Characteristics of human encephalitis caused by pseudorabies virus: A case series study
Characteristics of human encephalitis caused by pseudorabies virus: A case series study
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DOI：
10.1016/j.ijid.2019.08.007
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发表时间：
2019-10-01
影响因子：
8.4
通讯作者：
Liu, Yiming
中科院分区：
文献类型：
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作者：
Yang, Xue;Guan, Hongzhi;Liu, Yiming
背景：伪狂犬病病毒（PRV）一直被认为只在动物中引起疾病。然而，最近的研究表明，PRV也可以引起人类疾病。方法：这是一个病例系列研究。本文对5例临床表现为急性脑炎的病例进行了回顾性分析。病例介绍：5例患者均从事与猪有关的工作。他们的临床表现呈急性发作和快速进展，与中枢神经系统感染一致。其中4人呼吸衰竭，需要呼吸机支持。脑磁共振成像显示所有5名患者的双侧颞叶和岛叶皮质异常信号，1名患者的双侧额叶异常信号，1名患者的尾状核异常信号。脑脊液分析结果与病毒感染一致。下一代脑脊液测序证实了PRV的存在。所有患者均接受人免疫球蛋白、糖皮质激素、抗病毒药物和对症支持治疗。所有患者均存活至出院，但有各种后遗症。肺炎是最常见的并发症，在疾病course.Conclusions：PRV脑炎应包括在中枢神经系统感染的临床表现的患者的鉴别诊断，特别是对于那些最近接触过猪。(C)2019作者（S）由Elsevier Ltd代表国际传染病学会出版。
Background: Pseudorabies virus (PRV) has been thought to cause diseases only in animals. However, recent studies have shown that PRV can also cause illnesses in humans.Methods: This was a case series study. The cases of five patients with clinical symptoms of acute encephalitis, which were confirmed to be caused by PRV infections, were reviewed.Case presentation: The five patients all had jobs involving the handling of pigs. They had acute onset and rapid progression of clinical presentations, which were consistent with central nervous system infections. Four of them had respiratory failure, which required ventilator support. Brain magnetic resonance imaging showed abnormal signals in the bilateral temporal lobes and insular cortex in all five patients, bilateral frontal lobes in one patient, and caudate nucleus in one patient. Cerebrospinal fluid analysis results were consistent with a viral infection. Next-generation sequencing of the cerebrospinal fluid confirmed the presence of PRV. All patients received human immunoglobulin, glucocorticoids, antiviral agents, and symptomatic supportive treatments. All patients survived until discharge, but suffered from various sequelae. Pneumonia was the most common complication during the disease course.Conclusions: PRV encephalitis should be included in the differential diagnosis of patients with a clinical presentation of central nervous system infection, especially for those who have had recent contact with pigs. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.