Diagnostik und Therapie von ZNS-Infektionen bei pädiatrischen onkologischen Patienten

Zusammenfassung

Infektionen des zentralen Nervensystems (ZNS) sind eine der häufigsten Ursachen für neurologische Defizite bei pädiatrisch-onkologischen Patienten. Nicht immer manifestieren sich die Symptome eindeutig und erlauben daher keine scharfe Trennung von mannigfaltigen Differenzialdiagnosen. Die wiederholte klinisch-neurologische Untersuchung ermöglicht die gezielte Auswahl der notwendigen laborchemischen und neuroradiologischen Maßnahmen sowie der Erregerdiagnostik. Aufgrund der hohen Mortalität sowie Folgemorbidität bei verzögert antiinfektiös behandelten Patienten ist eine empirische Therapie mit adäquaten Dosen notwendig, bis diagnostische Hinweise zur spezifischen Behandlung führen. Die vorliegende Arbeit enthält Empfehlungen der Arbeitsgruppe „Infektionen bei immunsupprimierten Kindern” der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) und der Deutschen Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) zu Diagnosik und Therapie von ZNS-Infektionen bei immunsupprimierten Kindern.

Abstract

Infections of the central nervous system (CNS) are a common cause of neurological abnormalities in pediatric oncology patients apart from cancer disease of the CNS. Often symptoms do not present unequivocally, impeding a clear distinction from other differential diagnosis. Repeated neurological examinations of the patient allow selecting the necessary laboratory tests and imaging techniques. As delayed antiinfectious treatment is associated with high mortality and severe sequelae of survivors, patients do need empirical therapy using adequate doses until diagnostic results allow a more specific treatment. This article provides the recommendations of the Infectious Diseases Working Party of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Hematology/Oncology (GPOH) for diagnosis and treatment of infections of the CNS in immunocompromised patients.

zentrales Nervensystem - Infektionen - Onkologie - Kinder

central nervous system - infections - oncology - children

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