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米替福新:治疗由自由生活阿米巴引起的脑膜脑炎的神奇药物。

Miltefosine: A Miracle Drug for Meningoencephalitis Caused by Free-Living Amoebas.

作者信息

Alli Ammar, Ortiz Juan Fernando, Morillo Cox Álvaro, Armas Maria, Orellana Victor A

机构信息

Internal Medicine, Tishreen University Faculty of Medicine, Lattakia, SYR.

Internal Medicine, Universitat de Barcelona, Barcelona, ESP.

出版信息

Cureus. 2021 Mar 4;13(3):e13698. doi: 10.7759/cureus.13698.

Abstract

Meningoencephalitis caused by free-living amoebas (FLA) has a high mortality rate, and most treatments are ineffective. FLA includes Naegleria, Fowleri, Acanthamoeba, and Balamuthia mandrillaris (M). We explore the use of miltefosine in the treatment of one of these infections. The concerning mortality of the infection obligates us to look for more effective treatments for meningoencephalitis caused by FLA. During this review, we will consolidate the knowledge of using miltefosine in these three infections. We will investigate the mechanism by which the drug is effective in these infections as well. After this comprehensive review, we should assess if miltefosine improves the mortality and prognosis of the infection with the information collected. We used a Medical Subject Headings (MeSH) search on PubMed. Inclusion criteria included papers written in the English language and human subjects research for the past 25 years. Until today, there are no definitive guidelines to be followed when treating such patients. However, miltefosine has demonstrated promising results. Miltefosine decreases the usual mortality rate in the three infections; however, there are few reports due to the low frequency of these infections. Almost all cases we documented have survived. More information needs to be gathered for the use of miltefosine for these infections.

摘要

由自由生活阿米巴(FLA)引起的脑膜脑炎死亡率很高,且大多数治疗方法无效。FLA包括福氏耐格里阿米巴、棘阿米巴和曼氏巴贝斯虫(M)。我们探索使用米替福新治疗其中一种感染。该感染令人担忧的死亡率迫使我们寻找更有效的治疗FLA引起的脑膜脑炎的方法。在本次综述中,我们将巩固使用米替福新治疗这三种感染的知识。我们还将研究该药物在这些感染中有效的机制。经过全面综述后,我们应根据收集到的信息评估米替福新是否能改善感染的死亡率和预后。我们在PubMed上使用医学主题词(MeSH)进行了检索。纳入标准包括过去25年用英语撰写的论文和人体研究。直到今天,治疗此类患者尚无明确的指导方针可循。然而,米替福新已显示出有希望的结果。米替福新降低了这三种感染的通常死亡率;然而,由于这些感染的发生率较低,相关报告较少。我们记录的几乎所有病例都存活了下来。对于米替福新用于这些感染的情况,还需要收集更多信息。

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