Olejnik Z, Lipowski D, Przyjałkowski W, Strzelecki R, Janeczko J, Baranowska M, Romanowska B
Kliniki Chorób Zakaźnych dla Dorosłych Instytutu Chorób Zakaźnych i Pasozytniczych AM w Warzawie.
Pol Tyg Lek. 1994;49(20-22):459-61.
The authors, basing on the own experience in the treatment of 578 patients with purulent meningitis and encephalitis, discuss etiologic and clinical problems as an early diagnosis of the cause decides on the proper therapy and often on the patient's fate. The authors are convinced that the result of general CSF examination is a crucial diagnostic criterion in meningitis and encephalitis but does not permit identification of the disease causes. Problems with etiological verification is discussed. The authors have found that the infection with N. meningitidis and S. pneumoniae remains the most frequent cause of the disease in adults. However, the cause of the disease cannot be determined in over 50% of patients, and etiological verification of infections caused by H. influenzae and anaerobic organisms is quite unsatisfactory. The authors stress that over 20% of patients had skull injury and meningitis most frequently resulted from the infection with S. pneumoniae in these patients. It is suggested that purulent meningitis and encephalitis as a rule is endogenous disease produced by the activation of endogenous source of the infection.
作者基于治疗578例化脓性脑膜炎和脑炎患者的自身经验，讨论了病因及临床问题，因为病因的早期诊断决定了恰当的治疗方案，且常常关乎患者的命运。作者坚信，脑脊液常规检查结果是脑膜炎和脑炎诊断的关键标准，但无法确定疾病病因。文中讨论了病因学验证方面的问题。作者发现，脑膜炎奈瑟菌和肺炎链球菌感染仍是成人该疾病最常见的病因。然而，超过50%的患者无法确定病因，对流感嗜血杆菌和厌氧菌所致感染的病因学验证也相当不理想。作者强调，超过20%的患者有颅脑损伤，这些患者的脑膜炎最常见由肺炎链球菌感染引起。建议化脓性脑膜炎和脑炎通常是由内源性感染源激活产生的内源性疾病。
