From the Transplantation-Oncology Infectious Diseases Program, Departments of Medicine, Pediatrics, and Microbiology and Immunology (M.M., T.J.W.), and the Departments of Neurology, Neuroscience, and Neurosurgery (A.R.) and Pathology and Laboratory Medicine (A.N.S.), Weill Cornell Medical Center of Cornell University, New York; and the Infectious Diseases Department and Division of Internal Medicine, University of Texas M.D. Anderson Cancer Center, Houston (D.P.K.).
N Engl J Med. 2014 Jul 10;371(2):150-60. doi: 10.1056/NEJMra1216008.
The recent outbreak of meningitis linked to epidural injections of methylprednisolone acetate has brought renewed attention to mold infections of the central nervous system (CNS). Although uncommon, these infections are often devastating and difficult to treat. This focused review of the epidemiologic aspects, clinical characteristics, and treatment of mold infections of the CNS covers a group of common pathogens: aspergillus, fusarium, and scedosporium species, molds in the order Mucorales, and dematiaceous molds. Infections caused by these pathogen groups have distinctive epidemiologic profiles, clinical manifestations, microbiologic characteristics, and therapeutic implications, all of which clinicians should understand.
最近与醋酸甲泼尼龙硬膜外注射相关的脑膜炎爆发,使人们再次关注中枢神经系统(CNS)的霉菌感染。尽管这些感染并不常见,但通常是毁灭性的,难以治疗。本文重点综述了中枢神经系统霉菌感染的流行病学方面、临床特征和治疗,涵盖了一组常见病原体:曲霉属、镰刀菌属和帚霉属、子囊菌门中的毛霉目和暗色真菌。这些病原体引起的感染具有独特的流行病学特征、临床表现、微生物学特征和治疗意义,临床医生都应该了解。