Management of Viral Central Nervous System Infections: A Primer for Clinicians.
Management of Viral Central Nervous System Infections: A Primer for Clinicians.
复制标题
DOI：
10.1177/1179573517703342
复制
发表时间：
2017
影响因子：
4.8
通讯作者：
Weissman S
中科院分区：
文献类型：
--
作者：
Bookstaver PB;Mohorn PL;Shah A;Tesh LD;Quidley AM;Kothari R;Bland CM;Weissman S
病毒是引起中枢神经系统（CNS）感染的常见原因，许多宿主、病原体和环境因素影响病毒疾病的表达。病毒可通过多种机制导致中枢神经系统疾病，包括中枢神经系统内的直接感染和复制导致脑炎、局限于脑膜的感染或免疫相关过程，如急性播散性脑脊髓炎。包括单纯疱疹病毒、水痘带状疱疹和肠病毒在内的常见病原体在免疫能力强的宿主中引起的病例最多。其他疱疹病毒（如巨细胞病毒、约翰·坎宁安病毒）在免疫功能低下的宿主中更为常见。乙型脑炎病毒和寨卡病毒等虫媒病毒是全球重要的病原体，但其流行率因地理区域和季节而异。从放射证据和分子（如快速）诊断中进行早期诊断对于靶向治疗非常重要。抗病毒药物可以有效地对付某些病原体，尽管有些病毒没有有效的治疗方法。本文综述了在中枢神经系统疾病中常见的病毒病原体的流行病学、诊断和管理。
Viruses are a common cause of central nervous system (CNS) infections with many host, agent, and environmental factors influencing the expression of viral diseases. Viruses can be responsible for CNS disease through a variety of mechanisms including direct infection and replication within the CNS resulting in encephalitis, infection limited to the meninges, or immune-related processes such as acute disseminated encephalomyelitis. Common pathogens including herpes simplex virus, varicella zoster, and enterovirus are responsible for the greatest number of cases in immunocompetent hosts. Other herpes viruses (eg, cytomegalovirus, John Cunningham virus) are more common in immunocompromised hosts. Arboviruses such as Japanese encephalitis virus and Zika virus are important pathogens globally, but the prevalence varies significantly by geographic region and often season. Early diagnosis from radiographic evidence and molecular (eg, rapid) diagnostics is important for targeted therapy. Antivirals may be used effectively against some pathogens, although several viruses have no effective treatment. This article provides a review of epidemiology, diagnostics, and management of common viral pathogens in CNS disease.