Resident, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India.
Assistant Professor, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India.
Trop Doct. 2021 Jan;51(1):48-57. doi: 10.1177/0049475520959905. Epub 2020 Oct 6.
Infections of the central nervous system (CNS) are a leading cause of mortality in low- and middle-income countries. We studied the spectrum, aetiology and outcome of CNS infections in 401 consecutive patients aged ≥12 years admitted at the medical emergency centre of PGIMER, Chandigarh, India. An aetiological diagnosis was made in 365 (91.0%) patients, with 149 (40.8%) microbiologically confirmed cases. CNS tuberculosis was the most prevalent cause (51.5%), followed by viral meningoencephalitis (13.9%), community-acquired bacterial meningitis (9.7%), cryptococcal meningitis (6.2%), scrub typhus meningoencephalitis (1.7%), neurocysticercosis (1.7%) and fungal brain abscess (1.7%). Human immunodeficiency virus (11.0%) and diabetes mellitus (6.2%) remained the usual predisposing conditions. We found a mortality rate of 27.9%, highest in cases without an aetiology (64.5%). Tuberculosis remained the most common cause; however, an increasing number of scrub typhus, dengue, fungal infections and non-classical bacterial pathogens may indicate a change in the epidemiology of community-acquired CNS infections in India.
中枢神经系统（CNS）感染是中低收入国家死亡的主要原因之一。我们研究了在印度昌迪加尔 PGIMER 医疗急救中心收治的 401 名年龄≥12 岁的连续患者中 CNS 感染的谱、病因和结果。在 365 名（91.0%）患者中做出了病因诊断，其中 149 名（40.8%）为微生物学确诊病例。CNS 结核是最常见的病因（51.5%），其次是病毒性脑膜脑炎（13.9%）、社区获得性细菌性脑膜炎（9.7%）、隐球菌性脑膜炎（6.2%）、丛林斑疹伤寒性脑膜脑炎（1.7%）、脑囊虫病（1.7%）和真菌性脑脓肿（1.7%）。人类免疫缺陷病毒（11.0%）和糖尿病（6.2%）仍然是常见的诱发因素。我们发现死亡率为 27.9%，无病因的患者死亡率最高（64.5%）。结核病仍然是最常见的病因；然而，越来越多的丛林斑疹伤寒、登革热、真菌感染和非典型细菌病原体可能表明印度社区获得性 CNS 感染的流行病学正在发生变化。
