中樞神經(jīng)系統(tǒng)感染-2ppt(文件)
【正文】 epatic 肝臟的 dysfunction (isoniazid異煙肼 , rifampin利福平 , and pyrazinamide吡嗪酰胺 ) ? polyneuropathy多神經(jīng)炎 (isoniazid) ? optic neuritis (ethambutol乙胺丁醇 ) ? seizures (isoniazid) ? ototoxicity 耳毒性 (streptomycin鏈霉素 ) 第三十五頁，共六十八頁。 Cerebral Cysticercosis 腦囊蟲病 第三十九頁，共六十八頁。 Pathology 病理上典型的包囊大小為 5~10mm，可有薄壁，或呈多個(gè)囊腔，內(nèi)有囊尾蚴。 第四十四頁，共六十八頁。 第四十八頁，共六十八頁。 if this is suspected myelography椎管 造影術(shù)should be performed. ? Protein is increased to 50100mg/dL, and glucose is 2050mg/dL in most cases. ? Complement fixation 補(bǔ)體結(jié)合 and hemagglutination紅血球凝聚 studies can assist in the diagnosis. 第五十一頁，共六十八頁。 ? 非活動(dòng)期： T1\T2加權(quán)像上多呈圓形低信號(hào)。 第五十五頁，共六十八頁。 ? MRI. Sagittal brain T2W images show cysticerci in the extraorbital muscles (arrow) (a) and tongue (arrows) (b) as well as in the cranial and cervical muscles. c Sagittal spine T2W image reveals hyperintense lesions in nearly every paraspinal muscle (arrows) 第五十九頁，共六十八頁。 these may progress to cause obstructive hydrocephalus梗阻性腦積水 . ? Single accessible intraparenchymal 腦實(shí)質(zhì)內(nèi)lesions can be removed surgically, and shunting分流術(shù) is required for intraventricular lesions causing hydrocephalus. 第六十二頁，共六十八頁。 第六十六頁，共六十八頁。藥物治療原那么：早期、聯(lián)合、足量、長期、頓服 第六十八頁，共六十八頁。 內(nèi)容總結(jié) TUBERCULOUS MENINGITIS。 第六十四頁，共六十八頁。 ? Albendazole, 阿苯達(dá)唑 15mg/kg/d in three doses taken with meals, and continued for 8 days, is the preferred therapy. ? Praziquantel, 吡喹酮 50mg/kg/d in three divided doses, can also be used, but blood levels are reduced by anticonvulsants 抗驚厥藥 and corticosteroids皮質(zhì)類固醇 , which are often required in these patients. 第六十一頁，共六十八頁。 第五十七頁，共六十八頁。 第五十三頁，共六十八頁。 MRI ? 活動(dòng)期： T1加權(quán)像囊蟲呈圓形低信號(hào)，頭節(jié)呈點(diǎn) 狀或逗點(diǎn)狀高信號(hào)， T2加權(quán)像囊蟲呈圓形高信號(hào)，頭節(jié)呈點(diǎn)狀低信號(hào)。 ? They include seizures, headache, focal neurologic signs, hydrocephalus腦積水 , myelopathy脊髓病 , and subacute meningitis. Peripheral blood eosinophilia 嗜酸性細(xì)胞增多癥 , soft tissue calcifications鈣化 , or parasites寄生蟲 in the stool 糞便suggest the diagnosis. 第五十頁，共六十八頁。 第四十六頁，共六十八頁。當(dāng)蟲體死亡或液化時(shí)，囊腔內(nèi)為暗褐色混濁液體，內(nèi)含大量蛋白質(zhì)、當(dāng)蟲體液化被吸收后囊腔變小，囊壁增厚，囊蟲死后常發(fā)生鈣化。 ?The disease follows ingestion of larvae 幼蟲 of the pork tapeworm (taenia solium豬肉絳蟲 ) and affects the brain in 6090% of cases. 第四十一頁，共六十八頁。 ? The risk of using corticosteroids may be high, however especially if tuberculous meningitis has been mistakenly diagnosed in a patient with fungal meningitis. Therefore, if fun
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