亚急性和慢性脑膜炎病因诊断的挑战:对 183 名患者的分析。

IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Epidemiology and Infection Pub Date : 2024-10-10 DOI:10.1017/S0950268824001225
Mahboubeh Haddad, Fereshte Sheybani, Matin Shirazinia, Farzaneh Khoroushi, Zahra Baghestani
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引用次数: 0

摘要

亚急性和慢性脑膜炎(SCM)是诊断方面的重大挑战,其感染性和非感染性炎症病因众多。本研究调查了 2015 年 3 月至 2022 年 10 月期间伊朗马什哈德市神经感染和神经炎症转诊中心收治的 16 岁及以上亚急性和慢性脑膜炎患者。在 183 次发病中,结核性脑膜炎是最常见的感染原因(46.5%),其次是布鲁氏菌脑膜炎(24.6%)。40.4%的病例明确证实了单核细胞增多症的病因,35.0%的病例推测病因,24.6%的病例病因不明。院内死亡率为 14.4%,30.5% 的幸存者出现了不良预后(格拉斯哥预后量表 2-4)。与推测或确诊的患者相比,病因不明的患者死亡风险明显更高(风险比为 4.18)。这项研究强调了单核细胞增多症的诊断难度,四分之一的病例仍未确诊,超过三分之一的病例仅有推测性诊断。改进诊断方法有可能改善预后并降低死亡率。
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The challenge of etiologic diagnosis of subacute and chronic meningitis: an analysis of 183 patients.

Subacute and chronic meningitis (SCM) presents significant diagnostic challenges, with numerous infectious and non-infectious inflammatory causes. This study examined patients aged 16 and older with SCM admitted to referral centers for neuroinfections and neuroinflammations in Mashhad, Iran, between March 2015 and October 2022. Among 183 episodes, tuberculous meningitis was the most common infectious cause (46.5%), followed by Brucella meningitis (24.6%). The cause of SCM was definitively proven in 40.4%, presumptive in 35.0%, and unknown in 24.6% of cases. In-hospital mortality was 14.4%, and 30.5% of survivors experienced unfavorable outcomes (Glasgow Outcome Scale 2-4). Patients with unknown causes had a significantly higher risk of death compared to those with presumptive or proven diagnoses (risk ratio 4.18). This study emphasizes the diagnostic difficulties of SCM, with one-quarter of cases remaining undiagnosed and over one-third having only a presumptive diagnosis. Improving diagnostic methods could potentially enhance prognosis and reduce mortality.

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来源期刊
Epidemiology and Infection
Epidemiology and Infection 医学-传染病学
CiteScore
4.10
自引率
2.40%
发文量
366
审稿时长
3-6 weeks
期刊介绍: Epidemiology & Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The scope covers the zoonoses, outbreaks, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease, as well as some tropical infections. It has become the key international periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections are of particular value.
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