Connolly K J, Hammer S M
Harvard Medical School, Boston, Massachusetts.
Infect Dis Clin North Am. 1990 Dec;4(4):599-622.
The acute aseptic meningitis syndrome is an entity that presents a diagnostic challenge to the clinician. Although many infectious and noninfectious etiologies exist for this syndrome, viruses, especially nonpolio enteroviruses, are the classic and most important agents encountered. The incidence of polio and mumps meningitis has declined dramatically in the vaccine era, but recently described pathogens, such as human immunodeficiency virus and Borrelia burgdorferi (Lyme disease agent) are now important considerations in the differential diagnosis. Specifically treatable entities (eg, mycobacterial or fungal meningitis, herpes simplex encephalitis, parameningeal infection) that may mimic aseptic meningitis in their initial presentations must not be overlooked. A careful approach to the patient and a rational use of laboratory studies are the basis for establishing a specific diagnosis and assuring a favorable outcome.
急性无菌性脑膜炎综合征是一种给临床医生带来诊断挑战的病症。尽管该综合征存在许多感染性和非感染性病因，但病毒，尤其是非脊髓灰质炎肠道病毒，是最常见且最重要的致病原。在疫苗时代，脊髓灰质炎和腮腺炎脑膜炎的发病率已大幅下降，但近期发现的病原体，如人类免疫缺陷病毒和伯氏疏螺旋体（莱姆病病原体），如今在鉴别诊断中成为重要的考虑因素。在初始表现上可能模拟无菌性脑膜炎的特定可治疗病症（如分枝杆菌或真菌性脑膜炎、单纯疱疹性脑炎、脑膜旁感染）绝不可被忽视。对患者进行细致评估并合理运用实验室检查，是确立明确诊断并确保良好预后的基础。
