导致脑膜炎的晚期埃博拉病毒复发:一个病例报告
Michael Jacobs1, Alison Rodger2, David J Bell3
1Department of Infection, Royal Free London NHS Foundation Trust, London, UK.
Lancet (London, England)
|May 23, 2016
概括
埃博拉病毒晚期复发可能发生在幸存者中,甚至在康复数月后,影响中枢神经系统. 这一发现凸显了埃博拉幸存者持续警潜在的新传染链的必要性.
科学领域:
- 传染性疾病
- 病毒学
- 神经学
背景情况:
- 埃博拉病毒 (EVD) 幸存者面临可能的长期并发症.
- 在免疫特权区域的病毒持续存在可能导致晚期复发.
- 此前没有描述过埃博拉病毒病的晚期严重复发.
研究的目的:
- 描述中枢神经系统 (CNS) 中埃博拉病毒晚期复发的情况.
- 研究晚期埃博拉病毒复发的临床过程和病毒学特征.
- 为埃博拉病毒幸存者的未来管理和公共卫生监测提供信息.
主要方法:
- 一名39岁的护士因埃博拉病毒病接受治疗,出院9个月后因脑膜炎症状再次入院.
- 在脑脊液 (CSF) 和血中检测到埃博拉病毒;进行病毒基因组测序.
- 患者接受了支持性治疗和实验性抗病毒药物GS-5734.
主要成果:
- 埃博拉病毒RNA在脑脊液中的含量高于血,感染性病毒仅从脑脊液中检测到.
- 患者患上脑膜炎,与皮质类固醇和GS- 5734治疗相关的临床康复.
- 在GS-5734治疗14天后,脑脊髓液中埃博拉病毒RNA变得无法检测;病毒基因组测序显示的变化很小.
结论:
- 埃博拉病毒感染的晚期严重复发可能发生,特别是在中枢神经系统.
- 这一发现需要重新评估埃博拉病毒感染的自然史.
- 由于公共卫生传播问题,对埃博拉幸存者的复发感染的持续警至关重要.
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