在老年患者中因爱斯坦-巴尔病毒引起的双边胸膜脑炎:病例报告和文献综述
Francesco Perrotta1, Federica Vitale2, Ludovica De Marco3
1Department of Anesthesia and Intensive Care, Azienda Ospedaliera "Cardinale G. Panico", Tricase (LE), Italy. francperr72@yahoo.it.
BMC neurology
|December 1, 2025
概括
爱斯坦-巴尔病毒 (EBV) 可以引起罕见的,严重的双边胸膜脑炎,导致神经系统的快速衰退. 这一案例凸显了诊断和治疗这种毁灭性的疾病的挑战,即使有迅速的医疗干预.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 病毒性脑炎是一种病毒性脑炎.
背景情况:
- 爱斯坦-巴尔病毒 (EBV) 感染很少表现为严重的双边体脑炎.
- 这种情况往往导致神经系统的快速恶化和患者的不良结果.
- 早期识别和理解对于管理这种罕见的神经复杂症至关重要.
研究的目的:
- 在老年患者中报告与EBV相关的双边胸膜脑炎病例.
- 审查与EBV相关的双边胸膜脑炎的文献,以提高理解.
- 为更好的诊断突出临床和放射学发现.
主要方法:
- 一个82岁的男性患有急性神经功能障碍的病例报告.
- 脑脊液 (CSF) 分析,EBV PCR,以及血清学.
- 磁共振成像 (MRI) 与扩散加权成像 (DWI) 和明显扩散系数 (ADC) 映射.
- 排除自身免疫,神经瘤和其他感染/炎症原因.
- 关于与EBV相关的双边胸膜脑炎的综合文献综述.
主要成果:
- 患者出现了发烧,昏迷 (GCS 3),以及CSF发现的淋巴细胞多细胞症和蛋白质升高.
- EBV-DNA和阳性抗EBVIgM证实了EBV感染.
- 核磁共振扫描显示了具有特征的双边 thalamic 超强度与受限制的扩散.
- 自身免疫和副瘤标志物是负的,不包括其他脑类.
- 尽管接受了治疗,但该患者的临床结果不佳.
结论:
- EBV可以引起严重的双边体脑炎,这对诊断提出了挑战.
- 典型的MRI发现对于诊断至关重要,除了病毒学确认外.
- 这种罕见的疾病,尽管有积极的管理,但预后往往不好.
- 需要进一步的研究和文献审查,以改善识别和治疗策略.
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