ZNS-Infektionen bei Immunsupprimierten

Zusammenfassung

Bei Immuninkompetenz ist das Erregerspektrum verändert und erweitert. Erreger, die bei Immunkompetenten keine Infektion auslösen können, müssen je nach Art der beeinträchtigten Immunabwehr berücksichtigt werden. Dementsprechend sind auch die Befunde in der zerebralen Bildgebung und in der Labor- und Liquordiagnostik verändert.

Abstract

The spectrum of CNS infections, the neurological aspects and the neuroradiological findings in immunocompromised patients differ from the immunocompetent ones and can be very variable. The differential diagnosis should include also rare and unusual infections. Therefore, it is essential to know what sort of patient has a disease. In addition, parenchymal reactions may occur as a result of inflammatory immune reconstitution syndrome when immune competence is restored.

Kernaussagen

• Essenziell ist die Kenntnis des Immunstatus des Patienten.

• Bei Immuninkompetenten sind seltene und ungewöhnliche Infektionen möglich.

• Das Spektrum der ZNS-Infektionen, bildmorphologische Befunde und klinische Aspekte bei Immunsuppression unterscheiden sich vom Immunkompetenten und können sehr variabel sein.

• Pathognomonische neuroradiologische Befunde gibt es nicht.

• Das Läsionsmuster, die Ausbreitung und kurzfristige Verlaufsuntersuchungen verbessern die richtige diagnostische Zuordnung.

• Goldstandard ist die Erregerbestimmung im Liquor, Blutkulturen oder mittels Biopsie.

Schlüsselwörter

ZNS-Infektion - Immunsuppression - opportunistische Infektion

Key words

infections of the central nervous system - immunosuppression - opportunistic infection

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