Benninger Felix, Steiner Israel
Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
Handb Clin Neurol. 2017;146:187-206. doi: 10.1016/B978-0-12-804279-3.00012-5.
Infections of the nervous system are an important and challenging aspect of clinical neurology. Immediate correct diagnosis enables to introduce effective therapy, in conditions that without diagnosis may leave the patient with severe neurological incapacitation and sometimes even death. The cerebrospinal fluid (CSF) is a mirror that reflects nervous system pathology and can promote early diagnosis and therapy. The present chapter focuses on the CSF findings in neuro-infections, mainly viral and bacterial. Opening pressure, protein and glucose levels, presence of cells and type of the cellular reaction should be monitored. Other tests can also shed light on the causative agent: serology, culture, staining, molecular techniques such as polymerase chain reaction. Specific examination such as panbacterial and panfungal examinations should be examined when relevant. Our chapter is a guide-text that combines clinical presentation and course with CSF findings as a usuaful tool in diagnosis of neuroinfections.
神经系统感染是临床神经学中一个重要且具有挑战性的方面。及时正确的诊断有助于实施有效的治疗，而在未进行诊断的情况下，可能会使患者出现严重的神经功能障碍，甚至有时导致死亡。脑脊液（CSF）是反映神经系统病理状况的一面镜子，能够促进早期诊断和治疗。本章重点关注神经感染时脑脊液的检查结果，主要是病毒和细菌感染。应监测初压、蛋白质和葡萄糖水平、细胞的存在情况以及细胞反应类型。其他检查也有助于明确病原体：血清学、培养、染色、分子技术如聚合酶链反应。相关时应进行特定检查，如泛细菌和泛真菌检查。我们这章是一篇指导性文本，将临床表现和病程与脑脊液检查结果相结合，作为诊断神经感染的有用工具。
