[Two adult patients with acute necrotizing encephalopathy following influenza virus infection].
[Two adult patients with acute necrotizing encephalopathy following influenza virus infection].
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DOI：
10.5692/clinicalneurol.cn-001381
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发表时间：
2020-02-27
期刊：
影响因子：
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通讯作者：
Hirata, Koichi
中科院分区：
文献类型：
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作者：
Iizuka, Kentaro;Suzuki, Keisuke;Hirata, Koichi
流行性感冒脑病的特征是感染流感病毒后出现高烧、意识障碍。我们遇到了2例与流感相关的成人急性坏死性脑病(例1，70岁女性糖尿病患者；例2，49岁女性多发性骨髓瘤患者)，双侧丘脑出现出血性病变。例1以发热、意识障碍为首发症状，继发癫痫持续状态，例2以发热、嗜睡为首发症状。1例A型流感阳性，2例B型流感阳性。急性期2例患者需要呼吸机治疗，并应用抗流感药物、类固醇和免疫球蛋白治疗。两名患者在慢性期仍存在认知障碍。当怀疑急性坏死性脑病时，应尽早开始强化治疗，以改善患者的临床转归。
Influenza encephalopathy is characterized by high fever, disturbance of consciousness following influenza virus infection. We encountered 2 adult patients with influenza-associated acute necrotizing encephalopathy (Case 1, a 70-year-old woman with diabetes; Case 2, a 49-year-old woman with multiple myeloma), showing hemorrhagic lesions in the bilateral thalamus. Case 1 presented with fever and disturbance of consciousness followed by status epilepticus, and Case 2 developed fever and drowsiness as initial manifestation. Influenza type A was positive in Case 1 and influenza type B was positive in Case 2. In the acute phase, 2 patients required respiratory ventilation and were treated with anti-influenza drug, steroid and immunoglobulin. Cognitive impairment remained in the both patients in the chronic phase. When acute necrotizing encephalopathy is suspected, intensive treatment should be started as early as possible to improve clinical outcome of patients.