Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS.
Herpes simplex virus type 2 meningoencephalitis resistant to acyclovir in a patient with AIDS.
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艾滋病患者体内对阿昔洛韦耐药的单纯疱疹病毒 2 型脑膜脑炎。
DOI：
10.1093/infdis/161.4.711
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Kohl,S
中科院分区：
文献类型：
--
作者：
Gateley,A;Gander,RM;Johnson,PC;Kit,S;Otsuka,H;Kohl,S
报告了一例由神经毒性胸苷激酶阳性（TK+） 2型单纯疱疹病毒（HSV）引起的复发性致命性脑膜脑炎，该病毒在静脉注射无环鸟苷治疗期间发生胸苷激酶缺乏（TK-）。一名艾滋病患者入院接受阿昔洛韦治疗持续性直肠周围疱疹性溃疡。他随后发展为脑膜脑炎。从脑组织活检标本中分离出一株TK+ 2型HSV。发生了进行性和致命的复发，并从他的脑脊液中分离出TK- 2型HSV。从肛周、脑和脑脊液分离的病毒DNA的限制性内切酶分析是相似的，表明它们是相同的病毒株。动物毒力研究表明，TK- islates免疫功能低下小鼠模型具有明显的皮肤毒力。这一病例值得注意，因为在过去，TK- HSV缺乏神经毒力，而且在治疗期间产生了阿昔洛韦耐药性并导致患者死亡。
A case is reported of relapsing fatal meningoencephalitis caused by a neurovirulent thymidine kinase-positive (TK+) type 2 herpes simplex virus (HSV) that developed thymidine kinase deficiency (TK-) during intravenous acyclovir therapy. A patient with AIDS was admitted for acyclovir treatment of a persistent perirectal herpetic ulcer. He subsequently developed meningoencephalitis. A TK+type 2 HSV was isolated from a brain biopsy specimen. A progressive and fatal relapse occurred, and a TK- type 2 HSV was isolated from his cerebrospinal fluid. Restriction endonuclease analysis of viral DNA from perianal, brain, and cerebrospinal fluid isolates were similar, suggesting that they were the same viral strain. Animal virulence studies indicated significant cutaneous virulence in immunocompromised mice models for the TK- is0lates. This case is notable because TK- HSV have, in the past, lacked neurovirulence and because acyclovir resistance developed during therapy and caused the patient's death.