A Case of Varicella-zoster Virus Meningitis without Rash Diagnosed by Multiplex PCR
A Case of Varicella-zoster Virus Meningitis without Rash Diagnosed by Multiplex PCR
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多重PCR诊断无皮疹的水痘带状疱疹病毒性脑膜炎一例
DOI：
10.11150/kansenshogakuzasshi.e22028
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
IMAMURA Takuji
中科院分区：
文献类型：
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作者：
NISHIMOTO Nagisa;SAKAI Ryota;OUME Masataka;UEYAMA Hirokazu;KAKISHITA Yui;HAMA Hirotaka;WAKAHARA Ryohei;NISHIMURA Akira;KANBAYASHI Daiki;NAKATA Keiko;IMAMURA Takuji
一个健康的，免疫功能正常的15岁女孩因头痛，发热和呕吐后意识丧失而被收治入院。呕吐和意识障碍迅速改善，无需任何特殊治疗。虽然有脑膜炎，由于持续头痛和发烧，脑脊液检查进行了入院第四天，这表明淋巴细胞增多，水痘带状疱疹病毒（VZV）DNA检测的多重PCR。患者4岁时有水痘病史。她接受了为期14天的静脉注射阿昔洛韦，治疗改为口服伐昔洛韦，再给药3天。她完全康复了，没有残留的神经功能缺损。VZV脑膜炎在儿童中的发生率很低，有报道称少数病例没有皮疹。一些诊断为无菌性脑膜炎而无皮疹的病例可能是VZV脑膜炎病例。多重PCR检测被认为是早期诊断和适当治疗的重要工具。
A healthy, immunocompetent 15-year-old girl was admitted to our hospital with headache, fever, and loss of consciousness after vomiting. The vomiting and consciousness disturbance improved promptly without any specific treatment. While there was meningism, due to the persistent headache and fever, a CSF examination was performed on the fourth day of admission, which revealed lymphocytic pleocytosis, and varicella-zoster virus (VZV) DNA was detected by Multiplex PCR. The patient gave a history of having had chickenpox at 4 years of age. She received a 14-day course of intravenous acyclovir, and the treatment was switched to oral valacyclovir, given for another 3 days. She made a full recovery, with no residual neurologic deficit. The frequency of VZV meningitis in children is low, and there have been reports of a few cases without skin rash. It is possible that some cases diagnosed as cases of aseptic meningitis without skin rash may be cases of VZV meningitis. Multiplex PCR testing is considered as being an important tool for early diagnosis and appropriate treatment.