纵向扩展性脊髓炎:是登革热的一种罕见的副传染性神经并发症
Andrés David Sastre-Martínez1, Lina María Garzón-López1, Raúl Andrés Vallejo-Serna2
1Internal Medicine Department, Universidad del Valle. Cali, Valle del Cauca. 760032, Colombia.
Diagnostic microbiology and infectious disease
|October 8, 2025
概括
登革热可能导致罕见的神经并发症,如纵向扩散性脑膜炎. 早期的皮质类固醇治疗导致患有这种登革热相关心膜炎的患者完全康复.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 登革热是一种蚊子传播的疾病,在约5%的病例中可能导致神经系统并发症.
- 纵向扩展性脊髓炎,影响三个或更多的脊柱段,是登革热的罕见并发症,通过直接的病毒入侵或免疫介导途径发生.
研究的目的:
- 报告与登革热相关的纵向扩散性脊髓炎病例.
- 突出诊断标准和治疗策略,为这种罕见的神经复杂症.
主要方法:
- 一个34岁的登革热男性的临床病例介绍.
- 诊断工作包括磁共振成像 (MRI) 和脑脊液 (CSF) 分析.
- 治疗涉及高剂量的静脉注射甲基prednisolone.
主要成果:
- 患者在疾病的第五天呈现了帕帕雷西斯和保留.
- 核磁共振扫描显示了广泛的脊髓病变 (T2-T12),脑脊液显示了淋巴细胞多细胞化.
- 在18个月的随访后,完全康复,没有复发.
结论:
- 副传染性纵向扩展性脊髓炎是一种罕见但显著的登革热的神经并发症.
- 诊断依赖于临床表现,MRI和CSF分析;PCR在病毒病时有用.
- 早期的皮质类固醇治疗是治疗的支柱,对于耐火病例还有其他选择.
相关概念视频
Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...


