Ruef C
Abteilung Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1994 Jun 25;124(25):1109-16.
Encephalitis is the result of focal or global inflammation of the brain caused by invasion of the brain parenchyma by viruses, bacteria, parasites or fungi. In addition, postinfectious encephalitis may result from immunological processes as a consequence of preceding viral infections such as measles. For most forms of viral encephalitis no specific therapy is available. Herpes simplex encephalitis may be diagnosed using modern laboratory techniques for detection of viral DNA without the need for brain biopsy. Herpes simplex encephalitis responds well to treatment with acyclovir, as does encephalitis caused by varicella-zoster virus, which typically occurs following cutaneous herpes zoster involving dermatomal distributions of the trigeminal nerve. In immunocompromised hosts many etiologies of encephalitis need to be considered. It is important to arrive at a precise diagnosis in order to choose appropriate therapeutic agents directed toward treatable pathogens such as Toxoplasma gondii and cytomegalovirus.
脑炎是由病毒、细菌、寄生虫或真菌侵入脑实质引起的局灶性或全脑性炎症的结果。此外,感染后脑炎可能是由先前病毒感染(如麻疹)引发的免疫过程导致的。对于大多数形式的病毒性脑炎,尚无特效治疗方法。单纯疱疹病毒性脑炎可通过现代检测病毒DNA的实验室技术进行诊断,无需进行脑活检。单纯疱疹病毒性脑炎对阿昔洛韦治疗反应良好,水痘 - 带状疱疹病毒引起的脑炎也是如此,这种脑炎通常发生在累及三叉神经皮节分布的皮肤带状疱疹之后。在免疫功能低下的宿主中,需要考虑多种脑炎病因。准确诊断很重要,以便选择针对可治疗病原体(如弓形虫和巨细胞病毒)的合适治疗药物。