猫病脑炎:对比率,临床特征和长期结果的新见解
Michal Yakubovsky1, Laliv Kadar2, Eugene Katchman3
1Gray Faculty of Medical and Health Sciences, Tel Aviv University, Israel.; Department of Infectious Diseases and Infection Control, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel..
概括
猫病 (CSD) 可以引起脑炎,呈现急性或亚急性. 虽然大多数患者康复了,但有些人经历了持久的认知问题,这凸显了对治疗方法的进一步研究的需要.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 猫病 (CSD) 通常是一种轻微的疾病,但罕见的神经并发症如脑炎也可能发生.
- 脑炎作为CSD的表现很少被报告,需要进一步的表征.
研究的目的:
- 确定CSD患者脑炎/脑膜脑炎的发病率,诊断模式,临床表现和结果.
- 为了确定与CSD相关的脑炎相关的明显的临床模式和预后因素.
主要方法:
- 利用国家中央诊断中心监测登记处识别脑炎/脑膜脑炎患者.
- 收集临床数据并进行长期随访,进行神经和认知评估.
- 使用扩展格拉斯哥结果量表 (GOSE) 评估患者的结果.
主要成果:
- 确定了19例 (0.5%的CSD队列) 的CSD脑炎/脑膜炎,常见症状包括猫接触,发烧和淋巴腺病变.
- 两种临床模式出现:急性 (发病速度快,恢复时间较短) 和亚急性 (渐进,恢复时间较长,通常在老年人中). 发作是经常发生的 (68%).
- 在大多数情况下 (79%),神经成像是正常的,结果通常是有利的,尽管42%的人在平均58个月后报告了持续的认知投诉.
结论:
- 中枢神经疾病脑炎/脑膜炎表现出不同的急性和亚急性形式.
- 预后通常是有利的,但恢复可能会延长,很大一部分人经历持续的认知缺陷.
- 需要进一步研究抗生素和皮质类固醇治疗的疗效.
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