Infectious Diseases Division and Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.
Tropical and Humanitarian Medicine Division, Geneva University Hospitals, Geneva, Switzerland.
Clin Microbiol Infect. 2019 Apr;25(4):408-414. doi: 10.1016/j.cmi.2018.12.035. Epub 2019 Jan 14.
Encephalitis and meningoencephalitis imply inflammation of the brain parenchyma, and comprise many diagnostic entities, such as various infections and causes of dysimmunity. The cause remains unknown in around 50% of cases.
To summarize the main infectious causes of encephalitis and meningoencephalitis acquired in Europe, and the diagnostic means to identify them.
PubMed, ECDC and WHO websites, personal experience.
The principal infectious causes of encephalitis and meningoencephalitis acquired in Europe in adults are discussed in this review, with special emphasis on the microbiological and imaging diagnostic approaches. The role of electroencephalography in diagnosing encephalitis is also mentioned. Among infections, viruses are more frequent than other pathogen types, and their epidemiology varies according to geographic area. A few bacteria, such as Listeria monocytogenes and Mycobacterium tuberculosis, are also to be considered. In contrast, parasites and fungi are rare encephalitis causes in Europe.
Identifying the causative pathogen of infectious encephalitis and meningoencephalitis is complex because of the variety of pathogens, the epidemiology of which is determined by geography and environmental factors. Furthermore, despite extensive microbiological testing, many cases of encephalitis remain of unknown origin. Brain magnetic resonance imaging and electroencephalography are useful complementary diagnostic tools, and newer unbiased sequencing technologies might help to fill in the diagnostic gap.
脑炎和脑膜脑炎意味着脑实质的炎症，包含许多诊断实体，如各种感染和免疫失调的原因。约 50%的病例病因仍不清楚。
总结在欧洲获得的脑炎和脑膜脑炎的主要感染性病因，并确定其诊断方法。
PubMed、ECDC 和世卫组织网站、个人经验。
本文综述了在欧洲成年人中获得的脑炎和脑膜脑炎的主要感染性病因，特别强调了微生物和影像学诊断方法。本文还提到了脑电图在诊断脑炎中的作用。在感染中，病毒比其他病原体类型更为常见，其流行病学因地理位置而异。少数细菌，如李斯特菌和结核分枝杆菌，也需要考虑。相比之下，寄生虫和真菌在欧洲很少引起脑炎。
由于病原体种类繁多，其流行病学由地理位置和环境因素决定，因此确定感染性脑炎和脑膜脑炎的病原体非常复杂。此外，尽管进行了广泛的微生物学检测，但许多脑炎病例仍无法确定病因。脑磁共振成像和脑电图是有用的辅助诊断工具，而较新的无偏测序技术可能有助于填补诊断空白。
