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一个患有疹病毒脑膜炎的病例与一般性水般的疹

Tomoko Yamaguchi¹, Mariko Okada¹, Takuya Fukuoka¹

¹Department of Neurology, Saitama Medical University, Saitama, JPN.

|February 10, 2025

概括

疹病毒 (VZV) 脑膜炎可以引起妄想,即使没有皮疹. 早期诊断至关重要,因为脑脊液中的VZVDNA证实了感染,有助于治疗决策.

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:

腹病毒 (Varicella zoster virus,VZV) 的重新激活会导致神经系统并发症.
脑膜炎是一种严重的VZV表现.
老年患者和患有肺癌等并发症的患者有更高的VZV重新激活的风险.

研究的目的:

报告一个没有皮肤表现的VZV脑膜炎病例.
突出在这种情况下的诊断挑战.
强调在急性认知衰退的差异诊断中考虑VZV的重要性.

主要方法:

一个91岁的男性患者的病例报告.
临床表现与急性渐进性妄想.
诊断工作包括脑MRI和脑脊液 (CSF) 分析.
聚合酶连锁反应 (PCR) 测试CSF的VZVDNA.

主要成果:

大脑MRI显示了多个小血管病变.
CSF PCR 证实了 VZV DNA 的存在.
患者的表现缺乏典型的皮肤喷发 (shingles).

结论:

VZV脑膜炎可以在没有皮肤病变的情况下发生,这给诊断带来了挑战.
患有风险因素 (如癌症) 的老年人容易受到VZV的重新激活.
在急性认知障碍患者的差异诊断中应包括VZV,即使没有皮疹.

关键词:

这是一种类似于水的皮疹.痴呆症痴呆症是一种痴呆症.扩散性黄囊炎是一种传播性黄囊炎.脑膜大脑炎是一种脑膜炎.疹病毒病毒 (VZV) 病毒 (VZV)

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