Department of Emergency Medicine and Center for Resuscitation Science, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA.
Neurocrit Care. 2012 Sep;17 Suppl 1:S66-72. doi: 10.1007/s12028-012-9751-8.
Bacterial meningitis and viral encephalitis, particularly herpes simplex encephalitis (HSE), are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because treatment is more effective if given early, the topic of meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. This protocol provides a practical approach to recognition of and urgent treatment for bacterial meningitis and HSE, including imaging and spinal fluid analysis, and discusses the choice of empirical treatments until the cause of infection is determined. Though uncommon in its full form, the typical clinical triad of headache, fever, and neck stiffness should alert the clinical practitioner to the syndromes. Early attention to the airway and maintaining normotension is crucial in treatment of these patients, as is rapid treatment with anti-infectives and, in some cases, corticosteroids.
细菌性脑膜炎和病毒性脑炎，特别是单纯疱疹性脑炎（HSE），是严重的神经感染性疾病，如果不能及时、有效地治疗，会导致不良的神经预后或死亡。由于早期治疗效果更好，因此选择脑膜炎和脑炎作为急诊神经生命支持方案的主题。本方案提供了一种实用的方法来识别和紧急治疗细菌性脑膜炎和 HSE，包括影像学和脑脊液分析，并讨论了在确定感染原因之前经验性治疗的选择。尽管其完整形式并不常见，但头痛、发热和颈项强直的典型三联征应引起临床医生对这些综合征的注意。治疗这些患者时，早期注意气道和维持正常血压至关重要，快速使用抗感染药物治疗，在某些情况下使用皮质类固醇也很重要。
