文献速递神经MRCT

神经类鼻疽的影像模式与地域流行特征

Neuromelioidosis in a nutshell-Pattern and Endemicity.
PubMed 文献 · Clin Radiol · 2026-05-09

本文为图示综述,结合病例展示类鼻疽伯克霍尔德菌所致脑和脊髓感染的影像模式。重点强调皮质脊髓束受累这一特征性表现,并讨论类似影像表现的鉴别诊断,以提高流行区临床决策和早期靶向抗生素治疗。

要点

  • 发热、意识改变、抽搐或头痛且常规治疗无效时,应考虑神经类鼻疽可能。
  • 影像上见到皮质脊髓束受累征象,要高度警惕神经类鼻疽。
  • 该病在东南亚、北澳及南印度部分沿海地区流行,需结合地域史判断。

核心结论

  • 影像识别类鼻疽伯克霍尔德菌所致脑和脊髓受累的典型模式,尤其是皮质脊髓束受累,对指导靶向抗生素治疗和改善生存至关重要。

研究设计与样本

  • 图示综述,通过病例展示说明神经类鼻疽的影像模式与地域流行特征。
  • 纳入病例均为类鼻疽伯克霍尔德菌感染累及脑和脊髓的病例,强调皮质脊髓束受累表现。

关键影像表现/征象

  • 特征性影像表现为皮质脊髓束受累。
  • 可见脑和脊髓受累的相应影像改变。
  • 文中讨论了与类似影像表现相关疾病的鉴别诊断要点。

临床应用与阅片要点

  • 对流行区来源的发热、意识改变、抽搐或头痛且常规治疗无效患者,影像阅片时主动寻找脑和脊髓受累模式。
  • 阅片中一旦发现皮质脊髓束受累,应将神经类鼻疽纳入鉴别诊断并提示临床启动靶向抗生素治疗。
  • 报告时应结合患者是否来自东南亚、北澳或南印度泰米尔纳德邦、卡纳塔克邦沿海等流行区。

局限性

  • 原文为图示综述,未提供系统检索、样本量及诊断准确性数据。

以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。

英文原文(摘要)· 点击展开

Timely and accurate imaging diagnosis is critical in cases of fever, altered sensorium, seizures, or headaches that do not respond to conventional clinical management. This pictorial essay aims to highlight, through case illustrations, the critical role of imaging in identifying Burkholderia pseudomallei-a rare but significant infectious agent responsible for a characteristic pattern of brain and spinal cord involvement. The condition, known as neuromelioidosis, is endemic in the tropical regions of Southeast Asia and Northern Australia including coastal regions of Tamil Nadu and Karnataka in South India. This review underscores the importance of recognising patterns associated with this disease, with emphasis on the characteristic and specific feature of corticospinal tract involvement. Correct diagnosis is necessary to guide the initiation of targeted antibiotic therapy, which is a critical step in initiating the urgent management required to improve survival outcomes. Furthermore, we provide a discussion of differential diagnoses associated with similar imaging findings, emphasising the need for a nuanced approach to diagnosis and management in such complex cases. By raising awareness of the geographical prevalence and imaging hallmarks of neuromelioidosis, this study aims to enhance clinical decision-making and improve outcomes in affected patients.

来源:Clin Radiol,查看原文。版权归原作者所有。

引用

  1. Janet Preethi Philomina, Sunitha, Adithan, et al. Neuromelioidosis in a nutshell-Pattern and Endemicity. Clin Radiol. 2026. PMID: 42284690. doi:10.1016/j.crad.2026.107381

供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。