Johns Hopkins Encephalitis Center, Department of Neurology, Johns Hopkins University School of Medicine, Meyer 6-113, 600 N. Wolfe Street, Baltimore, MD, 21287, USA,
Curr Infect Dis Rep. 2013 Dec;15(6):594-9. doi: 10.1007/s11908-013-0382-9.
Encephalitis results in substantial morbidity and mortality and is a challenging syndrome for clinicians to manage. The clinical presentation is heterogeneous, there is a broad range of causative agents, and specific treatments for many etiologies are lacking. Over the past decade, a number of novel infectious and autoimmune etiologies of encephalitis have been identified. Despite such advances, however, up to 50 % of encephalitis cases typically remain without an identified etiology. Moreover, few new vaccines and therapies have been developed. Here, we discuss recent advances in encephalitis, with specific focus on several areas: (1) the changing demographics of West Nile virus in the United States and the implications for vaccine development, (2) challenges in the diagnosis of herpesviral infections in immunocompromised individuals, (3) the identification of a potential link between herpes simplex encephalitis and anti-NMDA receptor encephalitis, and (4) the delineation of prognostic factors related to outcome in individuals with encephalitis.
脑炎可导致严重的发病率和死亡率,是临床医生面临的一大挑战。其临床表现多种多样,病因广泛,许多病因缺乏特定的治疗方法。在过去十年中,人们发现了许多新的感染性和自身免疫性脑炎病因。然而,尽管取得了这些进展,多达 50%的脑炎病例仍未明确病因。此外,开发的新疫苗和疗法寥寥无几。在此,我们讨论脑炎的最新进展,重点关注以下几个方面:(1) 西尼罗河病毒在美国的人口统计学变化及其对疫苗开发的影响;(2) 免疫功能低下个体疱疹病毒感染诊断的挑战;(3) 单纯疱疹脑炎与抗 N-甲基-D-天冬氨酸受体脑炎之间潜在联系的鉴定;(4) 明确与脑炎患者预后相关的预后因素。