Serviço de Neurologia, Hospital das Clínicas da Universidade Federal de Minas Gerais/EBSERH.
Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil.
Curr Opin Neurol. 2019 Feb;32(1):43-48. doi: 10.1097/WCO.0000000000000641.
To address the important relationships between stroke and infection, focusing on the most frequent infections found in low-income and middle-income countries.
Stroke is one of the leading causes of mortality and disability worldwide, with a great proportion of the stroke burden occurring in low-income and middle-income countries. Infectious diseases are still a great health problem in developing countries and it is possible that the proportion of infection-related strokes is greater in these nations. Infectious diseases and stroke have a bidirectional relationship. Common infections may act as risk factors and can trigger stroke through different mechanisms in their acute phase. Several intracranial and systemic infections can cause stroke as a direct complication, such as Chagas disease, neurosyphilis, tuberculous meningitis, and neurocysticercosis. These conditions are of particular interest to low-income and middle-income countries, but also relevant to high-income nations because of increasing migration. Finally, infection is a frequent poststroke complication, with great impact in the patient outcome.
Infectious diseases and stroke are common problems in low-income and middle-income countries. More studies are necessary to fully elucidate the real impact of infectious diseases on stroke burden, especially in countries where epidemiological data are still scarce.
目的综述：探讨中风与感染之间的重要关系，重点关注低收入和中等收入国家中最常见的感染。
最近发现：中风是全球范围内导致死亡和残疾的主要原因之一，而中风负担的很大一部分发生在低收入和中等收入国家。传染病仍然是发展中国家的一个重大健康问题，在这些国家，感染相关的中风比例可能更大。传染病和中风之间存在双向关系。常见的感染可能作为危险因素，并可能通过其急性期的不同机制引发中风。一些颅内和全身感染可引起中风，如恰加斯病、神经梅毒、结核性脑膜炎和脑囊虫病。这些疾病对低收入和中等收入国家特别关注，但由于移民增加，对高收入国家也很重要。最后，感染是中风后的常见并发症，对患者的预后有很大影响。
总结：传染病和中风是低收入和中等收入国家的常见问题。需要更多的研究来充分阐明传染病对中风负担的实际影响，特别是在那些流行病学数据仍然稀缺的国家。
