一个意想不到的后果:对中枢神经系统的菌感染和疫情的综述
Chia-Yu Chiu1, Rachel S Hicklen2, Luis Ostrosky-Zeichner3
1Division of Infectious Diseases, Department of Medicine, University of Colorado, Aurora, Colorado, USA.
Clinical microbiology reviews
|February 10, 2026
概括
有毒的中枢神经系统菌感染 (ICNSMIs) 很少见,但与受污染的药物相关的疫情正在增加. 早期诊断和治疗对于在这些严重的真菌感染中获得更好的结果至关重要.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 菌类学 菌类学是指菌类学.
背景情况:
- 中枢神经系统菌感染 (ICNSMIs) 是神经外科手术的不常见并发症.
- 最近的疫情与外科医院外围注射中使用的受污染药物有关.
- 这些感染存在重大风险,原因是某些菌物种的血管侵入性.
研究的目的:
- 对ICNSMIs进行全面的文献审查.
- 分析这些感染的特征,来源和结果.
- 评估ICNSMI的诊断和管理策略.
主要方法:
- 在没有日期限制的情况下对ICNSMIs的研究进行全面的文献审查,直到2025年7月.
- 905个报告病例的识别和分析.
- 基于菌物种,感染源和诊断/治疗策略的结果比较.
主要成果:
- 96%的确诊病例与五个已记录的疫情有关,主要与脊柱/外皮注射中受污染的药物有关.
- 由Fusarium solani和Aspergillus物种引起的感染显示,中风,出血,动脉瘤和死亡率更高.
- 脑脊液 (1→3) -β-D-葡萄糖的测量是一种有价值的预防性诊断工具.
结论:
- ICNSMIs,尤其是疫情爆发的ICNSMIs,需要及时诊断和管理,包括抗真菌疗法和源控制.
- 结果很差,死亡率很高 (35%在90天后) 和频繁的长期神经系统损伤.
- 有效的策略包括症状驱动或查腰部穿刺和脑磁共振成像,以及生物标志物监测.
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