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Neurogeriatrie pp 303–318Cite as

Infektionen und Nervensystem in der Geriatrie

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Zusammenfassung

Das Immunsystem des Menschen ist Alterungsvorgängen unterworfen, welche zu einer erheblichen Infektanfälligkeit führen. Die septische Enzephalopathie ist die mit weitem Abstand häufigste ZNS-Komplikation einer septischen Allgemeininfektion. Für die Erkrankung fehlen speziell auf den alten Menschen zugeschnittene diagnostische Kriterien. Oft liegen Mischbilder aus septischer Enzephalopathie und Exsikkose, Elektrolytstörungen, Niereninsuffizienz und/oder Medikamentennebenwirkungen (anticholinerge Nebenwirkungen zahlreicher Pharmaka) vor. Pathophysiologisch steht die Zytokin-induzierte Mikrogliaaktivierung durch die vermehrte Durchlässigkeit der Blut-Liquor-Schranke im Vordergrund. Auf der Neurotransmitter-Ebene scheinen Acetylcholin-Mangel und Dopamin-Überschuss den stärksten Einfluss auszuüben. Da es, abgesehen von adäquater Antibiotikagabe, keine spezifische Therapie der septischen Enzephalopathie gibt, ist die Infektionsvorbeugung beim geriatrischen Patienten besonders wichtig.

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Authors and Affiliations

  1. Evangelisches Krankenhaus Göttingen-Weende gGmbH, Geriatrisches Zentrum, Göttingen, Deutschland

    Marija Djukic & Roland Nau

  2. Neurologische Klinik, Universitätsklinikum Aachen, Aachen, Deutschland

    Simone C. Tauber

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  1. Marija Djukic
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  2. Simone C. Tauber
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Correspondence to Marija Djukic .

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  1. Klinik für Neurologie, UKSH, Campus Kiel, Kiel, Germany

    Walter Maetzler

  2. Lehrstuhl für Geriatrie, Universitätsklinikum Essen, Geriatriezentrum Haus Berge, Contilia Group, Essen, Germany

    Richard Dodel

  3. Klinik für Geriatrie mit Neurologie, Johanniter Krankenhaus Bonn, Bonn, Germany

    Andreas H. Jacobs

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Djukic, M., Tauber, S.C., Nau, R. (2019). Infektionen und Nervensystem in der Geriatrie. In: Maetzler, W., Dodel, R., Jacobs, A. (eds) Neurogeriatrie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57358-7_18

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