Acute flaccid paralysis: the spectrum of a newly recognized complication of West Nile virus infection
Acute flaccid paralysis: the spectrum of a newly recognized complication of West Nile virus infection
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DOI：
10.1016/j.jinf.2004.10.005
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发表时间：
2005-08-01
影响因子：
28.2
通讯作者：
Moorman, J
中科院分区：
文献类型：
--
作者：
Saad, M;Youssef, S;Moorman, J
目标。急性弛缓性麻痹（AFP）最近已成为与西尼罗河病毒（WNV）感染相关的主要中枢神经系统并发症。 WNV 感染中 AFP 的临床表现及其后遗症尚未得到充分研究。方法。我们描述了三名因 WNV 感染而患有 AFP 的患者，并回顾了来自已发表研究的 56 名患有该并发症的患者的临床表现。结果。 AFP 和 WNV 患者表现出一系列疾病，从单肢瘫痪到脑神经受累的四肢瘫痪。患者通常出现呼吸衰竭（54%）和膀胱功能障碍（22%）。虽然发烧几乎普遍存在（92%），但脑膜痉挛的症状并不常见（17%）。脑脊液 (CSF) 分析通常显示适度的细胞增多，影像学检查无法诊断。所有幸存者均出现持续性神经功能障碍；总体死亡率很高（22%），并且与瘫痪程度和高龄相关。结论。西尼罗河病毒中的 AFP 与显着的死亡率和长期发病率相关。 (C) 2004 年英国感染协会。由爱思唯尔有限公司出版。保留所有权利。
Objectives. Acute flaccid paralysis (AFP) has recently emerged as a major central nervous system complication associated with West Nile virus (WNV) infection. The spectrum of clinical presentations of AFP in WNV infection and its sequelae have not been well-studied.Methods. We describe three patients with AFP due to WNV infection and review the clinical presentations of 56 patients with this complication derived from published studies.Results. Patients with AFP and WNV presented with a spectrum of illness ranging from single extremity paralysis to quadriparalysis with cranial nerve involvement. Patients commonly developed respiratory failure (54%) and bladder dysfunction (22%). While fever was nearly universal (92%), signs of meningismus were less common (17%). Cerebrospinal fluid (CSF) analysis generally revealed a modest pleocytosis, and imaging studies were not diagnositic. Persistent neurologic impairment occurred in all survivors; overall mortality rate was high (22%) and was associated with both the extent of paralysis and advanced age.Conclusion. AFP in the setting of WNV is associated with significant mortality and tong-term morbidity. (C) 2004 The British Infection Society. Published by Elsevier Ltd. All rights reserved.