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1、InfectionsofCentralNervousSystemSectionone:SurveyⅠ.concept:allkindsofpathogensoforganismsintrudeintocerebralparenchyma,cerebralmembrane,vasculatureet.al,causingacuteorchronicdiseaseofinflammation.Ⅱ.pathogenvirus、bacteria、spirochet、worms、rickettsia、prion.ⅢInfection’site1.pa
2、renchyma:encephalitis,myelitisencephalomyelitis.2.meninges:meningitis,pachymeningitis.3.bothofparenchymaandmeninges:meningoencephalitis.ⅣInfection’spathway1.infectionthroughcirculation2.directinfection:trauma,otitismedia3.retrogradealongperipheralnervesSectiontwoherpessimp
3、lexvirusencephalitisⅠ.concept:Itisinflammationofthebrainparenchyma,causedbyherpessimplexvirus.Ⅱetiologyandmechanism1.etiology:HSV,HSVisaneurotrophicDNAvirus(Ⅰ、Ⅱmold)2.mechanism:HSV-Ⅰ：90percent1)Originalonset2)succeedonsetHSV-Ⅱ:6to15percent,neonateⅢpathology1.hemorrhagicnec
4、rosis:inbilateraltemporal,frontallobe.2.CowdryAinclusion:intranucleareosinophilicinclusionⅣclinicalmanifestation1.anyageandanyseason,acuteattack.2.prodromicsymptom3.mentalsymptom4.convulsion5.disturbanceofconsciousness6.focalsymptom:7.meningealirritationⅤinvestigation1.EEG
5、2.CTorMRI3.CSF4.pathogenofCSF1)antigen2)antibody3)HSV－DNAⅥdiagnosis1.clinicaldiagnosis1)recurrentorrecentherpesinfection2)fever,headache,mentalsymptomconvulsion,disturbanceofconsciousness,focalsigns.3)CSF,EEG,CT,MRI4)responsivetospecificantivirusagent2definitediagnosisbesi
6、destheabove,thefollowingsareneeded1)CSF:HSV－antigen,HSV－Ab2)brainbiopsyorpathology:Cowdryinintranuclear3)CSF:theDNAoftheHSV(PCR)4)cerebraltissueorspecimenoftheCSF:HSV5)exceptotherviralencephalitisⅦdifferentialdiagnosisOtherviralencephalitis－pathogenPsychosisDemyelinationdi
7、seaseⅧtreatment1、antiviroticchemotherapy:Acyclovir；Cancilovir2、immunetherapy:interferon、trans-factor、corticosteroids3、supportivetherapy:water-electrolytebalanceinfection:antibioficsICP:mannitolSectionthreeCryptococcosisⅠ.definition:cryptococcosisisoneofthemostcommonlyfunga
8、linfectionofCNS,themeningitisiscausedbycryptococcus.Ⅱ.etiology:cryptococcusⅢPathogenesis1
