一个日本老年患者的吸入性肺炎病例与疹简单脑炎
Ayaka Harada1, Yuichiro Iwamoto1, Yoshiro Fushimi1
1Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan.
Internal medicine (Tokyo, Japan)
|December 24, 2025
概括
老年患者有不明原因的意识变化可能患有简单疹脑炎 (HSE). 正常的脑脊液 (CSF) 发现不应该排除HSE,特别是在老年人中.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 老年病的医生 老年病的医生
背景情况:
- 吸气性肺炎可能导致老年人出现严重并发症.
- 老年人的精神状态变化需要彻底调查.
- 简单疹脑炎 (HSE) 是一种罕见但严重的神经疾病.
研究的目的:
- 报告在异常表现的老年患者中出现的HSE病例.
- 突出考虑老年患者的健康与安全的重要性,即使有正常的CSF,也会有不明原因的意识变化.
- 强调老年人群中HSE的诊断挑战.
主要方法:
- 一个94岁的女性因吸气肺炎入院的案例报告.
- 对临床表现,诊断成像 (MRI) 和脑脊液 (CSF) 分析进行了审查.
- 在CSF中检测到简单疹病毒1型 (HSV-1) DNA证实了诊断.
主要成果:
- 患者出现了吸入性肺炎,随后精神状况恶化.
- 大脑MRI显示了对边缘脑炎可疑的发现.
- 最初的脑液分析是正常的,但在医院5日检测到HSV-1DNA,证实了HSE.
- 在诊断时开始使用阿西克洛维尔治疗.
结论:
- 在老年患者中,应考虑简单疹脑炎,这些患者表现出不明原因的意识变化.
- 正常的CSF发现并不排除在老年人群中诊断HSE.
- 早期诊断和治疗HSE对于有利的结果至关重要,即使在老年患者中也是如此.
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