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
Korrespondenz
Dr. med. Matthias Klein
Neurologische Klinik und Poliklinik Klinikum Großhadern Ludwig-Maximilians-Universität
München
Marchioninistraße 15
81377 München
Email: matthias.klein@med.uni-muenchen.de
