Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-280, San Francisco, CA 94143, USA.
Department of Neurology, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA; Department of Medicine, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
Neurol Clin. 2022 Feb;40(1):77-91. doi: 10.1016/j.ncl.2021.08.006.
Infectious meningitis and encephalitis are associated with significant morbidity and mortality worldwide. Acute bacterial meningitis is rapidly fatal and early recognition and institution of therapy are imperative. Viral meningitis is typically a benign self-limited illness. Chronic meningitis (defined as presenting with >4 weeks of symptoms) is most often caused by tuberculosis and fungal infection. Because the diagnostic testing for tuberculous meningitis is insensitive and cultures often take weeks to grow, therapy is often initiated empirically when the diagnosis is suspected. Human simplex virus encephalitis is the most common cause of encephalitis and requires prompt treatment with intravenous acyclovir.
传染性脑膜炎和脑炎在全球范围内与较高的发病率和死亡率相关。急性细菌性脑膜炎迅速致命，早期识别和治疗至关重要。病毒性脑膜炎通常是一种良性的自限性疾病。慢性脑膜炎（定义为出现症状>4 周）最常见的病因是结核分枝杆菌和真菌感染。由于结核性脑膜炎的诊断检测不敏感，且培养通常需要数周才能生长，因此当怀疑诊断时，通常会经验性地开始治疗。单纯疱疹病毒脑炎是脑炎最常见的病因，需要立即静脉注射阿昔洛韦进行治疗。
