伤寒组Rickettsia社区获得的细菌中枢神经系统感染:我们必须超越常规!
Pauline B Roxas1, Justice Cruz2, Nicole Rae Horelka3
1Family Medicine Residency, Detar Healthcare System - Texas A&M University School of Medicine, Victoria, TX, USA.
Journal of the neurological sciences
|October 24, 2024
概括
伤寒组病 (TGR) 可以导致严重的中枢神经系统感染. 早期的多西环林治疗对于迅速康复和预防严重的神经系统并发症至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 由Rickettsia typhi和Rickettsia prowazekii引起的伤寒小组风病 (TGR) 是全球分布的载体传播疾病,发病率越来越高.
- 中枢神经系统感染是TGR的严重表现,表现为发烧,头痛和焦点神经症状等症状,如果不治疗,可能导致继发症或死亡.
研究的目的:
- 系统地审查自2015年以来公布的Rickettsia typhi脑膜大脑炎的记录病例.
- 在美国德克萨斯州南海岸增加了5例TGR病例.
- 提供TGR病理生理学的图形解释.
主要方法:
- 按照PRISMA指南进行系统的文献审查.
- 包括来自德克萨斯州南海岸的五个额外的TGR病例.
- 临床表现的分析,CSF发现和神经成像.
主要成果:
- 脑脊液可能表现出高开口压力,多细胞体,高蛋白或低葡萄糖比,但也可以正常.
- 神经成像可能会显示脑膜增强或内高血压,但发现可能是正常的.
- 多西环林治疗导致症状迅速消失.
结论:
- 建议在特有病区对中枢神经系统症状不明的患者进行常规TGR测试.
- 在流行地区的社区获得的细菌性脑膜炎指南中,应考虑对小鼠伤寒的实证治疗.
- 在全球范围内,加强TGR的实验室诊断能力是必不可少的.
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