BMJ Best Practice
最后审核时间： 十月 2018
最近更新时间： 一月 2018

小结

定义

病史和查体

关键诊断因素

  • 存在的危险因素
  • 进行性头痛
  • 严重头痛
  • 脑膜刺激征
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其他诊断因素

  • 恶心或呕吐
  • 发热
  • 意识水平下降
  • 颅神经麻痹
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危险因素

  • HIV 感染
  • 皮质类固醇的使用
  • 潜在慢性疾病（例如，恶性肿瘤、器官衰竭、自身免疫疾病、器官移植）
  • 暴露至受污染土壤、禽类粪便或蝙蝠洞穴
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诊断性检查

首要检查

  • CT和/或MRI头部扫描
  • 真菌血液培养（3组）
  • 血清隐球菌抗原检测
  • 血清+尿液组织胞浆菌抗原
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需要考虑的检查

  • 组织病理学及活检培养：受累脑膜、脑、非神经系统受累部位
  • PCR
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新兴检查

  • 18F-FDG PET/CT
  • CSF（1-3）-β-D-葡聚糖
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治疗流程

急性

隐球菌

组织胞浆菌病

球孢子菌

念珠菌

嘴突脐孢

曲霉属真菌

毛霉菌病

贡献者

作者 查看所有

Consultant Neurologist

Clinical Lead of Neuroinflammation

Department of Neurology

Queen's Hospital

Romford

UK

利益冲突披露
AC has received honoraria, speaker fees, and sponsorship for attending meetings from the following pharmaceutical companies during the past 3 years: Novartis, Biogen Idec, Eisai, Terumo BCT, Genzyme. Financial compensations received from his pharmaceutical consultancy have been publicly declared in the UK disclosure website of the Association of the British Pharmaceutical Industry (ABPI). AC declares that these interests do not influence or compromise his role as a contributor.

Dr Abhijit Chaudhuri would like to gratefully acknowledge Dr Thomas S. Harrison and Dr Angela Loyse, previous contributors to this monograph. TSH and AL declare that they have no competing interests.

Associate Professor of Medicine

University of Southern California

Keck School of Medicine

Los Angeles

CA

利益冲突披露
RAL declares that he has no competing interests.

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