Severe fever with thrombocytopenia syndrome bunyavirus-related human encephalitis
Severe fever with thrombocytopenia syndrome bunyavirus-related human encephalitis
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DOI：
10.1016/j.jinf.2014.08.001
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发表时间：
2015-01-01
影响因子：
28.2
通讯作者：
Cao, Wu-Chun
中科院分区：
文献类型：
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作者：
Cui, Ning;Liu, Rong;Cao, Wu-Chun
背景：发热伴血小板减少综合征（SFTS）是一种由新型布尼亚病毒引起的新发传染病。直到最近，sftsv相关的脑炎在很大程度上仍未得到调查。方法：对河南省某参比医院2011 - 2013年收治的SFTS脑炎患者进行临床调查，探讨脑炎发生的危险因素及其致命结局发展。结果：共纳入538例SFTS患者，其中19.1%发生脑炎。脑炎患者死亡发生率为44.7%。与脑炎发生和死亡相关的危险因素包括年龄较大、发病和入院之间延迟时间较长、既往存在糖尿病和肌痛，以及入院时病毒载量较高、WBC、PLT计数下降、淋巴细胞百分比和ALB、中性粒细胞百分比升高、AST、ALT、LDH、CK、ALP、GGT、BUN和CREA。这些参数可作为严重SFTS病例的潜在预测指标。从脑脊液中分离出1株SFTSV病毒。细胞因子/趋化因子分析显示，确诊脑炎患者在临床恶化前，血液中EOTAXIN、ifn - γ、IL-15、IL-6、IP-10、tnf - α均显著升高。结论：SFTSV可感染中枢神经系统，应在SFTS流行地区对不明原因脑炎进行SFTSV筛查。脑炎的发生和致命结局可以通过临床和实验室评价来预测。(C) 2014年英国感染协会。Elsevier Ltd.出版。版权所有。
Background: Severe Fever with Thrombocytopenia Syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus. Until recently, SFTSV-associated encephalitis remained largely uninvestigated.Methods: We made clinical investigation on SFTS patients who experienced encephalitis in one reference hospital in Henan Province from 2011 to 2013 to identify the risk factors for encephalitis occurrence and their fatal outcome development.Results: Altogether 538 SFTS patients were included and 19.1% of them developed encephalitis. Fatal outcome occurred in 44.7% of the encephalitis patients. The risk factors associated with encephalitis occurrence and death included older age, longer delay between disease onset and hospital admission, pre-existing diabetes and myalgias, as well as the laboratory evaluations of higher virus load on admission, decreased WBC, PLT count, lymphocyte percentage and ALB, elevated neutrophils percentage, AST, ALT, LDH, CK, ALP, GGT, BUN and CREA. These parameters could be used as potential predictors referring to severe SFTS cases. One SFTSV strain was isolated from cerebrospinal fluid sample. Cytokine/chemokine assay revealed that blood EOTAXIN, IFN-gamma, IL-15, IL-6, IP-10, TNF-alpha were remarkably elevated before clinical deterioration in the confirmed encephalitis patient.Conclusions: SFTSV is capable of infecting the central nervous system and screening for SFTSV in encephalitis of unknown reason should be performed in SFTS endemic regions. The encephalitis occurrence and fatal outcome could be potentially predicted by clinical and laboratory evaluations. (C) 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.