长期存在的登革热病毒病与主要眼部表现在肺移植接受者的肺部
Leong Shuen Loo1, Michael Zhang2, Jane Wells2
1Department of Infectious Diseases, The Canberra Hospital, Canberra, ACT, Australia.
BMC infectious diseases
|August 14, 2025
概括
这项案例研究强调了登革热在肺移植接受者的异常眼部表现,包括长时间的病毒存在和延迟的抗体反应. 管理这种需要平衡病毒清除与控制严重的眼睛炎症.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
- 移植手术 移植手术
背景情况:
- 登革热病毒 (DENV) 感染通常伴有全身症状,但眼部感染越来越多.
- 免疫功能低下的个体,如器官移植接受者,可能会经历非典型的DENV疾病轨迹,包括长期的病毒性病.
- 这个案例集中在一个肺移植接受者身上,患有登革热,主要是眼部并发症.
研究的目的:
- 描述一个肺移植接受者的罕见登革热病例.
- 为了突出这一免疫受损患者中主要是眼部表现和长期的病毒性血.
- 讨论在免疫受损宿主中管理登革热眼病的治疗挑战.
主要方法:
- 一个40岁的双边肺移植接受者患有囊性纤维化病的病例介绍.
- 临床评估包括眼科检查,登革热血清学,以及血清,尿液和水性幽默中的病毒RNA检测.
- 治疗涉及高剂量普雷迪尼索隆和免疫抑制的修改,并仔细监测病毒病和眼部状态.
主要成果:
- 患者出现了头痛,双侧视,视敏度恶化,这表明眼睛受到影响 (黄斑,视网膜炎,视网膜血管炎).
- 检测到登革热血清型1RNA,血清学最初显示阳性NS1和IgM,阴性IgG.
- 观察到延长性病毒性血清 (69日清除) 和延迟的IgG血清转化 (319日). 视力敏度随着治疗而改善,尽管残留的黄斑仍然存在.
结论:
- 登革热可以在免疫受损的宿主中呈现异常,影响眼睛等免疫特权区域.
- 在移植受体中管理登革热眼病需要平衡免疫媒介病毒清除与控制炎症的需要.
- 进一步研究登革热病理生理学和治疗眼部干扰的治疗方案至关重要.
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