Frühdiagnose von Infektionen des zentralen Nervensystems – Eine Herausforderung für den behandelnden Arzt

Infektionen des Nervensystems stellen den behandelnden Arzt häufig vor eine große Herausforderung. Denn die Erkrankungen sind mit einer vergleichsweise hohen Letalität assoziiert. Eine frühzeitige gezielte antibiotische oder antivirale Behandlung ist daher von eminenter Bedeutung. Allerdings kann die Diagnose von Infektionen im zentralen Nervensystem schwierig sein: Sowohl bei der bakteriellen Meningitis, der Herpes-simplex-Enzephalitis als auch der Neuroborreliose sind die einzelnen Symptome nicht für die Erkrankung spezifisch, zum anderen können typische Symptome fehlen. Infolgedessen sind schnelle entsprechende ergänzende diagnostische Maßnahmen wichtig, um die Prognose durch eine gezielte frühe Therapie zu verbessern.

Infections of the nervous system often formidably challenge the treating physician, for these diseases are associated with a comparatively high rate of mortality. Hence, it is eminently important to start with an early targeted antibiotic or antiviral treatment. On the other hand, it may be difficult to pinpoint central nervous system infections. First of all, individual symptoms are not disease-specific for both bacterial meningitis and herpes simplex encephalitis as well as for neuroborreliosis, whereas typical symptoms may be absent. It is therefore imperative to quickly resort to suitable additional diagnostic devices to improve an early diagnosis and the prognosis by immediate targeted therapy.

Key words

bacterial meningitis - herpes simplex encephalitis - neuroborreliosis - clinical investigations and diagnosis - laboratory chemistry - targeted therapy

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1 FLuid Attenuation Inversion Recovery (T2-Wichtung mit Unterdrückung des Liquorsignals)

2 German Trial of Acyclovir and Corticosteroids in Herpes-simplex-virus-Encephalitis

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