Review/Advances in Neurological Therapeutics (2022). Neuroinfectious disease

Abstract

Influenza is an infectious disease that spreads every year ; however, it remains a disease with a high fatality rate and the potential for serious sequelae. It often presents with rapid exacerbations, diffuse cerebral edema, multiple organ damage, coagulation abnormalities, and requires treatment to suppress inflammatory cytokine production, manage vascular endothelial disorder, and prevent apoptosis in various organs. Treatment involves systemic management and specific approaches, such as antiviral, steroid, and gamma globulin therapies. In some cases, specialized treatment may be necessary.

The incidence of herpes zoster is also on the rise. When herpes zoster is complicated by central nervous system disorders, it can lead to severe and refractory cases, emphasizing the need for early diagnosis and treatment. Detecting VZV–DNA by cerebrospinal fluid PCR is a useful diagnostic tool, but it may not always be detected immediately after VZV reactivation. Recently, the use of the multiplex PCR method with high sensitivity and specificity has been recommended, providing test results within hours. In cases of suspected VZV central nervous system disorders, early administration of acyclovir is recommended.

In Japan, there has been a significant increase in syphilis, becoming a social issue. Untreated syphilis can progress to neurosyphilis, increasing the likelihood of encountering such cases in the future. Neurosyphilis can develop at any stage, and cerebrospinal fluid is crucial for diagnosis, while early treatment intervention with penicillin G plays a decisive role in determining the prognosis. Moreover, with benzylpenicillin becoming available in Japan in September 2021, the treatment of latent syphilis has become possible. Our future goals include preventing infection spread through preventive measures and minimizing sequelae through early diagnosis and intervention with timely treatment.