Infectious leukoencephalopathies.

Q2 Medicine
David Jakabek, Joga Chaganti, Bruce James Brew
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引用次数: 0

Abstract

Leukoencephalopathy from infectious agents may have a rapid course, such as human simplex virus encephalitis; however, in many diseases, it may take months or years before diagnosis, such as in subacute sclerosing panencephalitis or Whipple disease. There are wide geographic distributions and susceptible populations, including both immunocompetent and immunodeficient patients. Many infections have high mortality rates, such as John Cunningham virus and subacute sclerosing panencephalitis, although others have effective treatments if suspected and treated early, such as herpes simplex encephalitis. This chapter will describe viral, bacterial, and protozoal infections, which predominantly cause leukoencephalopathy. We focus on the clinical presentation of these infectious agents briefly covering epidemiology and subtypes of infections. Next, we detail current pathophysiologic mechanisms causing white matter injury. Diagnostic and confirmatory tests are discussed. We cover predominantly MRI imaging features of leukoencephalopathies, and in addition, summarize the common imaging features. Additionally, we detail how imaging features may be used to narrow the differential of a leukoencephalopathy clinical presentation. Lastly, we present an outline of common treatment approaches where available.

传染性白质脑病。
感染性病原体引起的白质脑病病程可能很快,如人类单纯疱疹病毒脑炎;但在许多疾病中,可能需要数月或数年才能确诊,如亚急性硬化性泛脑炎或惠普尔病。这种疾病的地理分布很广,易感人群包括免疫功能健全和免疫功能缺陷的患者。许多感染的死亡率很高,如约翰-坎宁安病毒和亚急性硬化性泛脑炎,但也有一些感染如单纯疱疹性脑炎,如果及早发现和治疗,治疗效果很好。本章将介绍主要导致白质脑病的病毒、细菌和原虫感染。我们将重点讨论这些感染病原体的临床表现,简要介绍流行病学和感染的亚型。接下来,我们将详细介绍目前导致白质损伤的病理生理机制。我们还讨论了诊断和确诊测试。我们主要介绍了白质脑病的磁共振成像特征,此外还总结了常见的成像特征。此外,我们还详细介绍了如何利用影像学特征缩小白质脑病临床表现的鉴别范围。最后,我们概述了可用的常见治疗方法。
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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来源期刊
Handbook of clinical neurology
Handbook of clinical neurology Medicine-Neurology (clinical)
CiteScore
4.10
自引率
0.00%
发文量
302
期刊介绍: The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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