埃普斯坦-巴尔病毒脑炎呈现为急性传播脑炎:一个具有挑战性的诊断困境
Neelanjana Pandey1, Arpan Chawala1, Sameer Kandhi1
1Internal Medicine, BronxCare Health System, Bronx, USA.
Cureus
|December 7, 2023
概括
爱斯坦-巴尔病毒 (EBV) 可以在健康个体中引起罕见的中枢神经系统 (CNS) 疾病. 这一案例凸显了EBV脑炎或ADEM在免疫能力强的患者中的诊断挑战.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 病毒学 病毒学
背景情况:
- 爱普斯坦-巴尔病毒 (EBV) 是一种常见的人类疹病毒,通常会影响淋巴系统.
- 中枢神经系统 (CNS) 受到EBV的影响很少见,造成诊断困难,特别是在免疫能力强的个体中.
研究的目的:
- 在健康的年轻女性中报告一种罕见的EBV脑炎/ADEM病例.
- 突出免疫能力低下,神经系统症状不明的患者的诊断挑战.
- 强调在中枢神经系统炎症状况的差异诊断中考虑EBV的重要性.
主要方法:
- 一个28岁的女性患有类似流感的疾病,进展到神经缺陷的病例报告.
- 最初的检查包括病毒面板和抗体;CSF分析显示白细胞和蛋白质的升高.
- 神经成像显示了非特异性的白质和脊髓损伤;重复成像显示大脑.
主要成果:
- 最初的诊断工作没有结论.
- 脑脊液 (CSF) 分析通过PCR意外证实了爱斯坦-巴尔病毒 (EBV).
- 尽管接受了常规治疗,但患者因扩散性脑而死亡.
结论:
- 在免疫能力强的个体中诊断EBV相关的中枢神经系统疾病是具有挑战性的,因为它是罕见的和非典型的表现.
- 负面的初步调查和非特异性的成像发现使诊断复杂化.
- 在无法解释的脑炎或ADEM中早期考虑EBV对于及时干预至关重要.
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