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慢性脑膜炎
Chronic Meningitis


Allen J. Aksamit ... 其他 • 2021.09.02

1987年,Morton Swartz医师在本刊就一篇论文发表了评论,上述论文的内容是脑脊液(CSF)血清学检测在脑膜孢子丝菌病诊断中的应用,他在评论中指出,临床医师面临慢性脑膜炎的问题时,有“许多病因需要考虑”1。与当时相比,如今慢性脑膜炎的病因,以及诊断检查和治疗方案列表更长,这使得该疾病的评估和治疗变得更为复杂。慢性脑膜炎的公认定义是脑膜炎症,且症状和体征至少持续4周无缓解2

新病原体已被添加到慢性脑膜炎的感染性原因列表中,而分子分析法如今提供了检测这些病原体的手段3。二代测序技术可鉴定病原体,且无预定结果的偏倚4。此外,由于长期免疫抑制治疗,机会性感染(如隐球菌性脑膜炎[在美国每年导致3,400例住院])5已变得与细菌性脑膜炎(每年3,600例)同样常见6

这篇简要综述提到了既往关于慢性脑膜炎的知识,并介绍了目前的治疗方法。本文考虑的是累及软脑膜或硬脑膜的疾病,但不包括脑实质,因为脑实质炎症将被称为脑炎。但有许多炎症性疾病同时累及脑膜和实质(脑膜脑炎)。





作者信息

Allen J. Aksamit, M.D.
From the Mayo Clinic, Rochester, MN. Address reprint requests to Dr. Aksamit at the Mayo Clinic, 200 First St., SW, Rochester, MN, 55905, or at aksamit@mayo.edu.

 

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