中枢神经系统念珠菌病的诊疗进展

Research advances in diagnosis and management of central nervous system candidiasis

中枢神经系统念珠菌病临床上相对少见,但病死率高。近年来,随着免疫低下人群和神经外科相关手术操作的增多,其发病率有明显上升的趋势。脑脊液培养和脑组织活检病理是诊断的金标准,但敏感性低。脑脊液抗原检测方法、分子诊断技术等非培养技术为其快速诊断提供了新的手段。目前抗真菌药物治疗策略初步成形,但最佳治疗方案和疗程尚无定论。本文对近年来中枢神经系统念珠菌病的相关诊断及治疗策略进行阐述。

Central nervous system candidiasis is relatively uncommon in clinic,but its mortality is high.In the past few years,with the increase of immunocompromised population and neurosurgery operations,the incidence of central nervous system candidiasis is showing a tendency to rise.Traditional diagnostic methods including cerebrospinal fluid culture and brain biopsy are gold standards,but their sensitivity is low.Nowadays,non-culture techniques,such as CSF antigen detection and molecular diagnostic techniques provide new means for rapid diagnosis.At present,the antifungal therapy is initially shaping,but the optimal therapy and duration of treatment have not been confirmed.In this paper,the diagnosis and treatment strategies of central nervous system candidiasis in recent years are described.