Infectious myelopathies
Infectious myelopathies
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DOI：
10.1055/s-2002-36536
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发表时间：
2002-06-01
影响因子：
2.7
通讯作者：
Sabet, A
中科院分区：
文献类型：
--
作者：
Berger, JR;Sabet, A
尽管传染性脊髓病很少见，但及时、准确的诊断对于改善预后至关重要。有许多生物体可能引起传染性脊髓病，包括人类免疫缺陷病毒 (HIV)、人类 T 细胞嗜淋巴细胞病毒 I 型 (HTLV-I)、疱疹病毒、肠道病毒、梅毒螺旋体、结核分枝杆菌、真菌和寄生虫。空泡性脊髓病是 HIV 感染者中最常见的脊髓疾病形式，但临床上尚未得到充分认识。未能诊断这种情况通常是将下肢无力和感觉异常归因于全身虚弱和伴随的周围神经病变的结果。热带痉挛性截瘫或 HTLV-I 相关脊髓病累及锥体束，主要在胸部水平，并导致痉挛性下肢无力和痉挛性膀胱。疱疹病毒（水痘带状疱疹病毒、2 型单纯疱疹病毒、巨细胞病毒）和肠道病毒可引起脊髓炎。在抗生素出现之前，梅毒是脊髓疾病最常见的感染原因。鉴于可能影响脊髓的病原体的广谱性以及这些疾病可能出现的多种方式，医生在对脊髓病患者进行鉴别诊断时必须始终考虑感染性病因。这篇综述讨论了微生物引起的感染性脊髓病。
Although infectious myelopathies are rare, timely and accurate diagnosis is essential to improving outcome. There are a number of organisms that may cause infectious myelopathies, including human immunodeficiency virus (HIV), human T-cell lymphotropic virus type I (HTLV-I), herpesviruses, enteroviruses, Treponema pallidum, Mycobacterium tuberculosis, fungi, and parasites. Vacuolar myelopathy, the most common form of spinal cord disease in HIV-infected individuals, is underrecognized clinically. The failure to diagnose this condition is generally a consequence of the attribution of the lower extremity weakness and paresthesias to general debility and concomitant peripheral neuropathy. Tropical spastic paraparesis or HTLV-I-associated myelopathy involves the pyramidal tracts, chiefly at the thoracic level, and results in spastic lower extremity weakness and a spastic bladder. The herpesviruses (varicella-zoster, herpes simplex type 2, cytomegalovirus) and the enteroviruses cause myelitis. Prior to the development of antibiotics, syphilis was the most frequent infectious cause of spinal cord disease. In light of the broad spectrum of pathogens that may affect the spinal cord and the variegate fashion in which these disorders may present, the physician must always consider an infectious etiology in the differential diagnosis for the patient presenting with myelopathy. This review addresses the infectious myelopathies by microorganism.