Klein M, Pfister H-W
Neurologische Klinik und Poliklinik, Klinikum Grosshadern, Universität München, Marchioninistrasse 15, Munich.
Nervenarzt. 2010 Feb;81(2):150-61. doi: 10.1007/s00115-009-2854-6.
Bacterial infections of the nervous system are often challenging for the treating physician because sensitivity and specificity of clinical signs do not reach 100%. In patients with neuroborreliosis and bacterial meningitis, investigations of the cerebrospinal fluid are necessary to confirm or rule out the diagnosis. In intracranial and spinal abscesses, the alterations of the cerebrospinal fluid are most often non-specific and imaging and neurosurgical aspiration of purulent material are additionally needed to make the diagnosis. Here, the relevant diagnostic and therapeutic aspects of three common bacterial infections of the central nervous system (neuroborreliosis, bacterial meningitis, and brain abscess) are discussed.
神经系统的细菌感染对治疗医生来说往往具有挑战性,因为临床体征的敏感性和特异性未达到100%。对于患有神经莱姆病和细菌性脑膜炎的患者,有必要对脑脊液进行检查以确诊或排除诊断。在颅内和脊髓脓肿中,脑脊液的改变通常是非特异性的,还需要进行影像学检查和对脓性物质进行神经外科穿刺抽吸以做出诊断。在此,将讨论中枢神经系统三种常见细菌感染(神经莱姆病、细菌性脑膜炎和脑脓肿)的相关诊断和治疗方面。