脊髓灰质炎病毒脑炎与先进的人类免疫缺陷病毒疾病通过脑部活检诊断
Yukihiro Yoshimura1, Dai Nakase1, Yuna So1
1Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Japan.
Internal medicine (Tokyo, Japan)
|October 27, 2024
概括
这项案例研究突出了在先进的人类免疫缺陷病毒 (HIV) 患者中罕见的疹病毒 (Varicella Zoster Virus,VZV) 大脑炎的例子. 尽管接受了治疗,神经系统并发症仍然存在,这凸显了VZV在免疫受损个体中的严重程度.
科学领域:
- 神经科学是一个神经科学.
- 传染性疾病 传染性疾病
- 病毒学 病毒学
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染严重影响免疫系统.
- 机会性感染在先进的艾滋病毒/艾滋病患者中很常见.
- 麻疹病毒 (Varicella Zoster Virus,简称VZV) 在免疫功能低下的个体中可能会导致严重的神经并发症.
研究的目的:
- 报告一个罕见的VZV脑炎病例在先进的艾滋病毒患者.
- 讨论这个人群中VZV脑炎的诊断挑战和临床表现.
- 突出获得免疫缺陷综合征 (艾滋病) 中VZV脑炎的预后和管理.
主要方法:
- 一个40岁的日本男子患有先进的艾滋病毒病例报告.
- 通过脑活检,实时聚合酶链反应 (PCR) 和VZV的免疫化学证实了诊断.
- 实验室测试包括CD4+淋巴细胞计数.
- 发现了与Mycobacterium avium和Pneumocystis肺炎的同时感染.
主要成果:
- 患者表现出意识障碍和瘦弱.
- CD4+淋巴细胞数量非常低 (4细胞/μL).
- 大脑活检证实了VZV脑炎,与传播的Mycobacterium avium感染和Pneumocystis肺炎同时存在.
- 患者在抗逆转录病毒治疗和静脉注射阿西克洛维尔后存活下来,有神经系统的后果.
结论:
- VZV脑炎是晚期艾滋病毒/艾滋病患者的罕见但严重并发症.
- 早期诊断和治疗至关重要,尽管神经系统的后果很常见.
- 这一案例强调了在具有神经症状的免疫受损患者中考虑VZV脑炎的重要性.
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