Imaging of Central Nervous System Infections in the Immunocompromised Patient

IF 0.1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Andrew Holmes, Mason Blue, Mark Diaz, Anthony Kuner, Megan Albertson
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Abstract

Immunocompromised patients are susceptible to the same infections as immunocompetent individuals and have an additional unique risk for atypical infections in the central nervous system (CNS). Many CNS infections carry a poor prognosis if not treated promptly, so it is prudent for radiologists to recognize key findings and have a high level of suspicion in immunocompromised patients. Moreover, a patient may have no known deficiency but can present with an atypical CNS infection as their first sign of an immunocompromised state, thus allowing the radiologist to be the first to suggest specific workup such as HIV testing. Because different infection sources (bacterial, fungal, and parasitic) have separate treatments, it is highly valuable to guide management in the right direction early in the diagnostic workup. This article discusses common opportunistic infections observed in the immunocompromised patient, primarily focusing on neuroimaging findings and pertinent clinical background and treatment for each disease entity. This article also emphasizes the importance of familiarity with the differential diagnosis for ring-enhancing lesions within the CNS.
免疫力低下患者中枢神经系统感染的影像学检查
免疫力低下的患者与免疫力正常的患者一样容易受到感染,而且中枢神经系统(CNS)的非典型感染风险更大。如果不及时治疗,许多中枢神经系统感染的预后都很差,因此放射科医生应该识别主要的检查结果,并高度怀疑免疫功能低下的患者。此外,患者可能没有已知的免疫缺陷,但可能出现非典型中枢神经系统感染,这是免疫功能低下的首发症状,因此放射科医生可以首先建议进行特定检查,如艾滋病检测。由于不同的感染源(细菌、真菌和寄生虫)有不同的治疗方法,因此在诊断工作的早期指导正确的治疗方向非常有价值。本文讨论了免疫功能低下患者常见的机会性感染,主要侧重于神经影像学检查结果以及每种疾病实体的相关临床背景和治疗。本文还强调了熟悉中枢神经系统环形强化病变鉴别诊断的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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