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Infektiologie > 5. Herpes-Simplex-Enzephalitis > Flashcards

5. Herpes-Simplex-Enzephalitis Flashcards

1
Q

(HSVE)

Erreger (2)

A
  • bei Erwachsenen: HSV-1
  • bei Säulingen: HSV-2
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2
Q

(HSVE)

Pathophysiologie

A

nekrotisierend-hämorrhagische Entzündung

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3
Q

(HSVE)

Letalität

A

90% (unbehandelt)

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4
Q

(HSVE)

Komplikationen

A

kognitive Defizite (Gedächtnisstörungen)

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5
Q

(HSVE)

Differenzialdiagnose

A

Autoimmunenzephalitis

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6
Q

(HSVE)

Autoimmunenzephalitis: Manifestation

A

limbische Enzephalitis

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7
Q

(HSVE)

Autoimmunenzephalitis: Serologie

A

LGI1-AK

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8
Q

(HSVE)

Autoimmunenzephalitis: Bildgebung der Wahl

A

MRT

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9
Q

(HSVE)

Autoimmunenzephalitis: Befunde in der Bildgebung

A

temporomediale multifokale Hyperintensitäten in T2 und FLAIR

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10
Q

(HSVE)

Autoimmunenzephalitis: Therapie

A

Glucocorticoide

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11
Q

(HSVE)

Symptome (2)

A
  • Allgemeinsymptome
  • neurologische und psychiatrische Symptome
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12
Q

(HSVE)

Allgemeinsymptome (3)

A

Trias

  • hohes Fieber
  • Kopfschmerzen
  • Abgeschlagenheit
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13
Q

(HSVE)

neurologische und psychiatrische Symptome (3)

A
  1. Bewusstseinsstörungen
  2. epileptische Anfälle
  3. fokale Defizite
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14
Q

(HSVE)

Bildgebung: 1. Wahl

A

MRT

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15
Q

(HSVE)

MRT-Befund

A

bilaterale asymmetrische Befunde in den Temporallappen

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16
Q

(HSVE)

MRT-Befund: Einbeziehung (2)

A
  • des limbischen Systems (Gyrus cinguli und Hippocampus)
  • Inselregion
17
Q

(HSVE)

MRT-Befund: Ausdehnung

A

nach frontobasal

17
Q

(HSVE)

Labor

A

Liquordiagnostik

18
Q

(HSVE)

Liquordiagnostik: Zellen

A

lymphozytäre Pleozytose mit mäßiger Zellzahlerhöhung

19
Q

(HSVE)

Liquordiagnostik: weitere Parameter

A
  • Glukose
  • Laktat
  • Liquor/Serum-Albuminquotient
  • Nachweis von Erythrozyten/Siderophagen
20
Q

(HSVE)

Liquordiagnostik:

  • Glukose
  • Laktat
  • Liquor/Serum-Albuminquotient
A
  • Glukose: normal
  • Laktat: normal oder leicht erhöht
  • Liquor/Serum-Albuminquotient: erhöht
21
Q

(HSVE)

apparative Diagnostik

22
Q

(HSVE)

EEG-Befund

A

generalisierte EEG-Rhythmusverlangsamung

23
Q

(HSVE)

medikamentöse Therapie: 1. Wahl

A

Aciclovir i.v. über 14d

24
Q

(HSVE)

Aciclovir: Nebenwirkung

A

nephrotoxisch

25
Q

(HSVE)

medikamentöse therapie: 2. Wahl

A

Foscarnet i.v. über 21d

26
Q

(HSVE)

Foscarnet: Indikation

A

bei Aciclovir-Resistenz

Infektiologie (17 decks)

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