Diagnosis of Acute Deer Tick Virus Encephalitis
Diagnosis of Acute Deer Tick Virus Encephalitis
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DOI：
10.1093/cid/cis938
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发表时间：
2013-02-15
影响因子：
11.8
通讯作者：
Wormser, Gary P.
中科院分区：
文献类型：
--
作者：
El Khoury, Marc Y.;Hull, Rene C.;Wormser, Gary P.
背景。鹿蜱病毒 (DTV) 是一种蜱传黄病毒，最近才被认为是病毒性脑炎的原因。我们描述了一名患者的临床表现，该患者在死亡前被诊断患有 DTV 脑炎，尽管存在严重的神经功能障碍，但仍存活了 8 个月。方法。使用黄病毒特异性聚合酶链反应测定从脑脊液样本中进行诊断，然后进行序列确认，并分析系统发育。还进行了血清学测试，包括噬菌斑减少中和测试。结果。分子分析表明，该病毒与 1996 年在马萨诸塞州肩胛硬蜱中和 2007 年在纽约一名患者脑中检测到的 2 种 DTV 病毒株密切相关。结论。在莱姆病流行地区的脑炎鉴别诊断中应考虑 DTV 脑炎。
Background. Deer tick virus (DTV) is a tick-borne flavivirus that has only recently been appreciated as a cause of viral encephalitis. We describe the clinical presentation of a patient who had DTV encephalitis diagnosed before death and survived for 8 months despite severe neurologic dysfunction.Methods. Diagnosis was made from a cerebrospinal fluid specimen, using a flavivirus-specific polymerase chain-reaction assay followed by sequence confirmation, and the phylogeny was analyzed. Serologic testing, including plaque reduction neutralization testing, was also performed.Results. Molecular analysis indicated that the virus was closely related to 2 strains of DTV that had been detected in Ixodes scapularis ticks from Massachusetts in 1996 and in the brain of a patient from New York in 2007.Conclusions. DTV encephalitis should be considered in the differential diagnosis of encephalitis in geographic areas that are endemic for Lyme disease.