Schmutzhard E
Neurologische Intensivstation, Universitätsklinik für Neurologie, Medizinische Universität-Innsbruck, Anichstrasse 35, Innsbruck, Austria.
Nervenarzt. 2010 Feb;81(2):162-71. doi: 10.1007/s00115-009-2853-7.
Central nervous system infections and infestations by protozoa and helminths constitute a problem of increasing importance throughout all of central European and northern/western countries. This is partially due to the globalisation of our society, tourists and business people being more frequently exposed to parasitic infection/infestation in tropical countries than in moderate climate countries. On top of that, migrants may import chronic infestations and infections with parasitic pathogens, eventually also--sometimes exclusively--involving the nervous system. Knowledge of epidemiology, initial clinical signs and symptoms, diagnostic procedures as well as specific chemotherapeutic therapies and adjunctive therapeutic strategies is of utmost important in all of these infections and infestations of the nervous systems, be it by protozoa or helminths. This review lists, mainly in the form of tables, all possible infections and infestations of the nervous systems by protozoa and by helminths. Besides differentiating parasitic diseases of the nervous system seen in migrants, tourists etc., it is very important to have in mind that disease-related (e.g. HIV) or iatrogenic immunosuppression has led to the increased occurrence of a wide variety of parasitic infections and infestations of the nervous system (e. g. babesiosis, Chagas disease, Strongyloides stercoralis infestation, toxoplasmosis, etc.).
原生动物和蠕虫引起的中枢神经系统感染和侵扰在整个中欧以及北欧/西欧国家正成为一个日益重要的问题。部分原因在于我们社会的全球化,相比气候温和的国家,游客和商务人士在热带国家更频繁地接触到寄生虫感染/侵扰。除此之外,移民可能会带入慢性寄生虫病原体感染,最终有时也会(有时仅仅)累及神经系统。对于所有这些由原生动物或蠕虫引起的神经系统感染和侵扰而言,了解流行病学、初始临床症状、诊断程序以及特定的化疗疗法和辅助治疗策略至关重要。本综述主要以表格形式列出了原生动物和蠕虫对神经系统所有可能的感染和侵扰。除了区分移民、游客等人群中出现的神经系统寄生虫病外,务必牢记与疾病相关的(如艾滋病病毒)或医源性免疫抑制导致了各种神经系统寄生虫感染和侵扰(如巴贝斯虫病、恰加斯病、粪类圆线虫侵扰、弓形虫病等)的发生率增加。