Matiash V I, Anisimova Iu N
Lik Sprava. 1997 May-Jun(3):94-9.
A total of 120 patients were examined presenting with a grave course of icterohemorrhagic leptospirosis; a pathomorphologic investigation of the brain from 75 deceased was done. Practically in all cases, the affection was accompanied by neurotoxicosis, with microcirculatory disturbances being its morphological substrate. The leading clinical syndromes of the affection of the central nervous system appeared to be general cerebral, meningeal, and encephalitic syndromes. Meningitis was diagnosed in 29.2%, meningoencephalitis in 5% of patients. Morphologic studies showed that predominantly focal serous meningitides and meningoencephalitides are significantly more common that they are diagnosed in clinical settings. They tend to develop during the second and third weeks of the course of the illness. Lumbal puncture is to be carried out on a differentiated basis only, since it may cause dysbalance in metabolic processes of the organism together with progression of those events being related to brain swelling.
共检查了120例黄疸出血型钩端螺旋体病病情严重的患者；对75例死者的大脑进行了病理形态学研究。实际上在所有病例中，病变均伴有神经中毒，微循环障碍是其形态学基础。中枢神经系统病变的主要临床综合征表现为全脑、脑膜和脑炎综合征。29.2%的患者被诊断为脑膜炎，5%的患者被诊断为脑膜脑炎。形态学研究表明，主要是局灶性浆液性脑膜炎和脑膜脑炎在形态学上比临床诊断更为常见。它们往往在病程的第二和第三周出现。腰椎穿刺只能在有区别的情况下进行，因为它可能导致机体代谢过程失衡，并伴随着与脑肿胀相关的事件进展。
