Infective Stroke
نویسندگان
چکیده
Dear Editor, Stroke is an important medical problem that requires good management. In medicine, stroke is the most common cause of disability around the world. The recent report on infective stroke is very interesting. 1 pointed out many interesting issues and mentioned a large number of tropical infections that can cause infective stroke. According to this report, malaria, tuberculosis, cysticercosis, syphilis, and Chagas disease are important examples of infective stroke. 1 In fact, several kinds of tropical infections (i.e. parasitic, bacterial, viral, or fungal infections) can lead to stroke. Moghtaderi and Alavi-Naini also noted that " Lack of human as well as financial resources makes it difficult to control and treat the disease properly. " 1 Indeed, the epidemiology of stroke in tropical countries is interesting. Gomes and Chalela et al. 2 noted that " Cerebrovascular disease is a leading cause of morbidity and mortality in tropical countries. " The authors also added to classical etiologies by mentioning " unusual causative mechanisms ". Tropical infections comprise an important group that merits due consideration. It has been noted that tropical infections accumulate " up to 10% of the cases of strokes in adults " in tropical countries. 3 The predominant tropical infections that can lead to tropical stroke might be different in different settings. For example, Chagas disease is predominant in South America, whereas gnathostomiasis is predominant in Southeast Asia. 3 However , some tropical infections that can cause stroke such as malaria and cysticercosis can be seen in many tropical as well as non-tropical areas. 3 Of interest, the clinical problems are sometimes underdiagnosed. For sure, this leads to the high mortality among the patients with specific tropical strokes. 3 As evidence, del Brutto et al. 4 mentioned that " The severity of the neurological picture makes it impossible to identify an specific stroke syndrome and cerebrovascular complications are only recognized on neuroimaging studies or autopsy. " This fact calls for medical attention to the forgotten problem of tropical stroke. Of interest, the problem of cryptogenic stroke still exists and incomplete investigation has been cited as the most important cause of it. 5 There is no doubt that those cryptogenic cases can have the exact underlying etiologies as tropical infections. 5 Indeed, in any setting, the differential diagnosis of stroke should include infection. It should be stressed that both tropical infectious and non-infectious diseases can be the etiologies of cerebral …
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