CYTOMEGALO-VIRUS AND HERPES-SIMPLEX VIRUS ASCENDING MYELITIS IN A PATIENT WITH ACQUIRED IMMUNE-DEFICIENCY SYNDROME
CYTOMEGALO-VIRUS AND HERPES-SIMPLEX VIRUS ASCENDING MYELITIS IN A PATIENT WITH ACQUIRED IMMUNE-DEFICIENCY SYNDROME
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DOI：
10.1002/ana.410180113
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发表时间：
1985-01-01
影响因子：
11.2
通讯作者：
SCHMIDLEY, JW
中科院分区：
文献类型：
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作者：
TUCKER, T;DIX, RD;SCHMIDLEY, JW
进行性上行性脊髓炎是一名同性恋男子获得性免疫缺陷综合征 (AIDS) 的主要特征，该男子还患有卡波西肉瘤、肺孢子菌肺炎和播散性巨细胞病毒 (CMV) 感染。神经病理学研究显示，整个大脑和脊髓中有大量巨细胞，但没有炎症反应。尸检时，在整个中枢神经系统的多个部位发现了 CMV 和 2 型单纯疱疹病毒 (HSV-2)。 HSV-2 是从肛门中分离出来的，但没有从其他神经外部位分离出来； CMV 的典型病理学也见于肝脏、胃肠道、肾上腺和肺。尽管组织病理学证据表明艾滋病患者的大脑中曾存在巨细胞病毒感染，但从未在这些免疫抑制宿主的中枢神经系统中培养出该病毒，也不知道该病毒会感染脊髓。炎症反应的缺失表明艾滋病患者中枢神经系统病毒感染的发病机制发生了改变。艾滋病患者中枢神经系统 CMV 感染的证据不再是间接证据。
Progressive ascending myelitis was the presenting feature of the acquired immune deficiency syndrome (AIDS) in a homosexual man who also had Kaposi''s sarcoma Pneumocystis pneumonia and disseminated cytomegalovirus (CMV) infection. Neuropathological studies showed profuse cytomegalic cells throughout the brain and spinal cord, but no inflammatory response. At postmortem examination, CMV and herpes simplex virus, type 2 (HSV-2), were recovered from multiple sites throughout the CNS. HSV-2 was isolated form the anus, but from no other extraneural site; pathology typical of CMV was also seen in the liver, gastrointestinal tract, adrenals and lungs. Although histopathological evidence suggesting prior CMV infection had been seen in the brains of AIDS patients, the virus had never been cultured from the CNS in these immunosuppressed hosts, nor had it been know to infect the spinal cord. The absence of an inflammatory response suggested that the pathogenesis of CNS viral infections was altered in AIDS patients. Evidence for CMV infection of the CNS in AIDS patients was no longer circumstantial.