感染症との鑑別を要する脳脊髄疾患

Central Nervous System Diseases That Are Difficult to Distinguish from Infection

Point

・感染性疾患との鑑別を要する疾患群は多岐にわたるが，脳神経外科医にとっては診療機会の少ない疾患もあり，鑑別疾患を慎重に想起しながら診療にあたる必要がある．

・画像所見のみでは，感染と腫瘍性疾患や自己免疫疾患などとの鑑別が困難な場合も多く，病歴や患者背景をもとに病態の把握に努めることが肝要である．

　It is often difficult to distinguish infectious disease of the central nervous system from a wide variety of non-infectious diseases, as neurosurgeons have few opportunities to treat them. Differentiation of infectious diseases from neoplastic diseases is often challenging. Since it often takes time to eliminate infectious diseases, it is necessary to utilize all the obtained medical information to make a proper diagnosis to avoid missing the appropriate chance of surgical treatment. In this paper, we describe tips for and pitfalls of accurately distinguishing such diseases, including brain abscess versus glioblastoma, meningitis versus dural lesions, and infection versus lymphoproliferative disorders in immunocompromised patients. In these cases, it is difficult to make a decision based only on the examination and imaging findings on admission, and it is important to make a diagnosis based on medical history and patient background.