Primary neuroleptospirosis
Primary neuroleptospirosis
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DOI：
10.1136/pmj.77.911.589
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发表时间：
2001-09-01
影响因子：
5.1
通讯作者：
Jayakumar, RV
中科院分区：
文献类型：
--
作者：
Panicker, JN;Mammachan, R;Jayakumar, RV
钩端螺旋体病是一种重要的人畜共患病，分布于世界各地。钩端螺旋体病以原发性神经系统疾病的形式出现并不常见。在这项研究中，病人谁提出了一个急性神经系统疾病，并随后发现有钩端螺旋体病，无菌性脑膜炎是最常见的表现。其他表现为脊髓神经根病、脊髓病、格林-巴利综合征样表现、脑膜脑炎、脑内出血、小脑功能障碍、虹膜睫状体炎和震颤/强直。治疗包括抗生素，晶体青霉素是首选药物，如果早期使用，可以缩短病程。类固醇的作用是有争议的。原发性神经钩端螺旋体病的预后一般较好，但感觉改变和癫痫发作预示着预后较差。
Leptospirosis is an important zoonosis of worldwide distribution. It is uncommon for leptospirosis to present as a primary neurological disease. In this study of patients who presented with an acute neurological disease, and who were subsequently found to have leptospirosis, aseptic meningitis was the commonest manifestation. The other presentations were myeloradiculopathy, myelopathy, Guillain-Barre syndrome-like presentation, meningoencephalitis, intracerebral bleed, cerebellar dysfunction, iridocyclitis, and tremor/rigidity. Treatment consists of antibiotics, crystalline penicillin being the drug of choice, which reduces the course of illness if given early. The role of steroids is controversial. The prognosis after primary neuroleptospirosis is generally good but altered sensorium and seizures herald a worse prognosis.