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成人脑膜炎病因的快速诊断方法。

Methods for rapid diagnosis of meningitis etiology in adults.

机构信息

Department of Medicine, University of Kansas, Kansas City, KS 66160, USA.

Division of Infectious Diseases & International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.

出版信息

Biomark Med. 2020 Apr;14(6):459-479. doi: 10.2217/bmm-2019-0333. Epub 2020 Apr 9.

DOI:10.2217/bmm-2019-0333
PMID:32270693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7248681/
Abstract

Infectious meningitis can be caused by viral, bacterial or fungal pathogens. Despite widely available treatments, many types of infectious meningitis are still associated with significant morbidity and mortality. Delay in diagnosis contributes to poor outcomes. Cerebrospinal fluid cultures have been used traditionally but are time intensive and sensitivity is decreased by empiric treatment prior to culture. More rapid techniques such as the cryptococcal lateral flow assay (IMMY), GeneXpert MTB/Rif Ultra (Cepheid) and FilmArray multiplex-PCR (Biofire) are three examples that have drastically changed meningitis diagnostics. This review will discuss a holistic approach to diagnosing bacterial, mycobacterial, viral and fungal meningitis.

摘要

感染性脑膜炎可由病毒、细菌或真菌病原体引起。尽管有广泛的治疗方法，但许多类型的感染性脑膜炎仍与显著的发病率和死亡率相关。诊断延迟导致不良预后。传统上使用脑脊液培养，但经验性治疗会降低培养的敏感性，并且耗时。更快速的技术，如隐球菌侧向流检测（IMMY）、GeneXpert MTB/Rif Ultra（Cepheid）和 FilmArray 多重 PCR（Biofire），是改变脑膜炎诊断的三个例子。这篇综述将讨论一种全面的方法来诊断细菌性、分枝杆菌性、病毒性和真菌性脑膜炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d4/7248681/bec4448dbd64/bmm-14-459-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d4/7248681/396d7bc8caf6/bmm-14-459-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d4/7248681/bec4448dbd64/bmm-14-459-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d4/7248681/396d7bc8caf6/bmm-14-459-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d4/7248681/bec4448dbd64/bmm-14-459-g2.jpg

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Inadequate diagnostics: the case to move beyond the bacilli for detection of meningitis due to Mycobacterium tuberculosis.诊断不足：需要超越杆菌检测结核分枝杆菌引起的脑膜炎。
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