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CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

Please always quote using this URN: urn:nbn:de:bvb:20-opus-188210
  • Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients. However,Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients. However, identification of CNS infections in immunocompromised patients could represent a major challenge since metabolic disturbances, side-effects of antineoplastic or immunosuppressive drugs and CNS involvement of the underlying hematological disorder may mimic symptoms of a CNS infection. The prognosis of CNS infections is generally poor in these patients, albeit the introduction of novel substances (e.g. voriconazole) has improved the outcome in distinct patient subgroups. This guideline has been developed by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) with the contribution of a panel of 14 experts certified in internal medicine, hematology/oncology, infectious diseases, intensive care, neurology and neuroradiology. Grades of recommendation and levels of evidence were categorized by using novel criteria, as recently published by the European Society of Clinical Microbiology and Infectious Diseases.show moreshow less

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Metadaten
Author: M. Schmidt-Hieber, G. Silling, E. Schalk, W. Heinz, J. Panse, O. Penack, M. Christopeit, D. Buchheidt, U. Meyding-Lamadé, S. Hähnel, H. H. Wolf, M. Ruhnke, S. Schwartz, G. Maschmeyer
URN:urn:nbn:de:bvb:20-opus-188210
Document Type:Journal article
Faculties:Medizinische Fakultät / Medizinische Klinik und Poliklinik II
Language:English
Parent Title (English):Annals of Oncology
Year of Completion:2016
Volume:27
Issue:7
Pagenumber:1207-1225
Source:Annals of Oncology (2016) 27:7, 1207-1225. https://doi.org/10.1093/annonc/mdw155
DOI:https://doi.org/10.1093/annonc/mdw155
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Bone-marrow-transplantation; Central nervous system; Central nervous system infection; Clinical practice guidelines; Diagnosis; Guideline; Herpes simplex encephalitis; Immunocompromised patient; Invasive fungal-infections; Liposomal amphotericin-B; Polymerase chain raction; Progressive multifocal leukoencephalopathy; Real-time PCR; Treatment; Varicella-zoster-virus
Release Date:2020/06/18
Licence (German):License LogoCC BY-NC: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell 4.0 International