Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA.
Curr Opin Infect Dis. 2021 Jun 1;34(3):207-216. doi: 10.1097/QCO.0000000000000722.
Significant advances to our understanding of several neuroinfectious complications after a solid organ transplant (SOT) have occurred in the last few years. Here, we review the central nervous system (CNS) infections that are relevant to SOT via a syndromic approach with a particular emphasis on recent updates in the field.
A few key studies have advanced our understanding of the epidemiology and clinical characteristics of several CNS infections in SOT recipients. Risk factors for poor prognosis and protective effects of standard posttransplant prophylactic strategies have been better elucidated. Newer diagnostic modalities which have broad clinical applications like metagenomic next-generation sequencing, as well as those that help us better understand esoteric concepts of disease pathogenesis have been studied. Finally, several studies have provided newer insights into the treatment of these diseases.
Recent findings reflect the steady progress in our understanding of CNS infections post SOT. They provide several avenues for improvement in the prevention, early recognition, and therapeutic outcomes of these diseases.
在过去的几年中,我们对实体器官移植(SOT)后几种神经感染并发症的认识有了重大进展。在这里,我们通过综合征方法来回顾与 SOT 相关的中枢神经系统(CNS)感染,特别强调该领域的最新进展。
一些关键的研究增进了我们对 SOT 受者中几种 CNS 感染的流行病学和临床特征的理解。预后不良的危险因素以及标准移植后预防策略的保护作用得到了更好的阐明。新的诊断方法,如宏基因组下一代测序,具有广泛的临床应用,以及那些帮助我们更好地理解疾病发病机制的深奥概念的方法,也得到了研究。最后,一些研究为这些疾病的治疗提供了新的见解。
最近的发现反映了我们对 SOT 后脑脊液感染认识的稳步进展。它们为这些疾病的预防、早期识别和治疗结果的改善提供了几个途径。