中枢神经系统真菌感染诊断治疗进展

中枢神经系统真菌感染发生率近年有逐渐增高之趋势,颅内真菌感染可分为弥漫性感染和局灶性感染,临床表现多为脑膜炎、脑膜脑炎引起的发热和颅高压症状,以及由颅内占位性病变所致的局灶性神经缺损症状。中枢神经系统真菌感染的诊断需将病史、流行病学、基础疾病、临床表现、影像学表现和各项实验室检查结果等综合分析,脑组织或脑脊液标本中找到真菌是诊断的金标准。中枢神经系统真菌感染的治疗原则是有效控制致病危险因素,使用有效抗真菌药物,对真菌脓肿、肉芽肿等进行积极手术干预。同时应积极探索新的诊断、治疗方法,以期改善患者预后。

The diagnosis and treatment of fungal infections in central nervous system

The incidence of fungal infections in central nervous system(CNS) has been increased recently.Intracranial fungal infections includs diffuse infections and focal infections,the clinical presentations were fever and intracranial hypertension due to meningitis,meningoencephalitis and even focal neurological deficits.The diagnosis of intracranial fungal infections depends on the case history,epidemiology,underlying diseases,clinical manifestations,imaging findings and laboratory examinations,while the golden standard is the identification of the fungi in brain tissue or cerebral spinal fluid.Controlling the underlying risks,administering effective antifungal drugs and removing fungal abscesses are the treatment principles for CNS fungal infections.New diagnostic and therapeutic approaches need to be explored to improve the prognosis of these patients.