神経感染症の治療の進歩

抄録

Since the reclassification of coronavirus disease 2019 (COVID–19) as a Category 5 infectious disease in Japan in May 2023, two years have passed, and society has gradually returned to a pre–pandemic state. However, new challenges have emerged in the field of neuroinfectious diseases. In recent years, the use of biological and immunosuppressive agents in the treatment of neuroimmunological disorders has markedly increased. Consequently, there is growing concern about the potential resurgence of invasive meningococcal disease (IMD), which had declined during the pandemic due to public health measures.

Progressive multifocal leukoencephalopathy (PML), a rare but often fatal demyelinating disease of the central nervous system, is associated with immunosuppressive therapies and is caused by reactivation of the JC virus (JCV), a member of the Polyomaviridae family. In addition, the varicella–zoster virus (VZV), for which routine immunization with an inactivated vaccine was introduced in Japan in 2025, is known to cause a broad spectrum of neurological complications―including postherpetic neuralgia, paralysis, meningitis, and encephalitis―that can significantly impair quality of life.

This review provides an overview of the current epidemiological trends, pathophysiological mechanisms, diagnostic considerations, and preventive strategies for three major neuroinfectious diseases―IMD, PML, and VZV–associated neurological disorders―in the context of post–pandemic neurological practice.