2016 年 33 巻 2 号 p. 150-154
Meningitis and encephalitis are severe neurological infections that, if treated late and ineffectively, lead to poor neurological outcome or death. Since treatment is more efficient if given early, these conditions of meningitis and encephalitis should represent as a life–threatening neurological emergency. The management of patients with suspected meningitis or encephalitis begins with empiric treatments until the causal agent of infection is determined. However, the etiologic organism cannot always be distinguished. The goal is to identify those that are treatable, provide supportive care for those that are not, and, when possible, prevent the neurologic complications of these infections. In this article, the author will present some representative cases to describe the characteristic magnetic resonance imaging and spinal fluid analysis of bacterial meningitis, tuberculous meningitis, cryptococcal meningitis, herpes simplex encephalitis, and anti–NMDA receptor encephalitis, and discusses the choice of empirical treatments until the cause of infection is determined. Also the differential diagnosis of meningitis and encephalitis is reviewed, with an emphasis on infectious etiologies.
