人类伪狂犬病毒感染性脑炎的诊断与治疗

doi:10.3969/j.issn.1672-6731.2024.04.002

摘要/Abstract

摘要：

自2017年至今，我国已报道28例人类伪狂犬病毒感染性脑炎病例，临床主要表现为发热、头痛、癫痫发作、局灶性神经功能缺损、意识障碍等，病残率和病死率较高。伪狂犬病毒主要通过接触感染的动物或其排泄物或者经血液传播，患者多为生猪产业链从业者。早期诊断、及时干预对预后至关重要。本文综述人类伪狂犬病毒感染性脑炎的诊断与治疗进展，以提高临床诊断与治疗水平。

关键词: 疱疹病毒1型，猪, 脑炎，病毒性, 综述

Abstract:

Since 2017, human encephalitis caused by pseudorabies virus (PRV) has been reported in 28 cases in China. The clinical symptoms include fever, headache, seizures, focal neurological loss, disturbance of consciousness, etc.. This disease has the high disability rate and fatality rate. PRV is mainly transmitted through close contact with infected pigs or their excrement, or spread via blood - borne. Patients are mostly practitioners in the live pig industry chain. Early diagnosis and treatment are critical to the prognosis of patients. Therefore, this article reviews the progress on diagnosis and treatment of human encephalitis caused by PRV, in order to improve the clinical diagnosis and treatment of this disease.

Key words: Herpesvirus 1, suid, Encephalitis, viral, Review

王晓娟, 蒋玙舒, 秦灵芝, 张弥兰, 王佳伟, 李玮. 人类伪狂犬病毒感染性脑炎的诊断与治疗[J]. 中国现代神经疾病杂志, 2024, 24(4): 203-207.

Xiao-juan WANG, Yu-shu JIANG, Ling-zhi QIN, Mi-lan ZHANG, Jia-wei WANG, Wei LI. Diagnosis and treatment of pseudorabies virus infectious encephalitis in human[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(4): 203-207.

http://journal11.magtechjournal.com/cjcnn/CN/Y2024/V24/I4/203

图/表 3

图 1 头部MRI检查所见 1a 横断面T₁WI可见明确的左眼视网膜脱离，呈“V字征”（箭头所示） 1b 横断面T₁WI局部放大后，左眼“V字征”更清晰（粗箭头所示），可疑右眼视网膜脱离（细箭头所示） 1c 横断面抑脂FLAIR成像显示，双侧颞叶内侧、颞极高信号影，以左侧为著（箭头所示） 1d 横断面抑脂FLAIR成像显示，双侧岛叶皮质、前扣带回和基底节区高信号影（箭头所示）

Figure 1 Brain MRI findings Axial T₁WI showed a clear "V sign" of retinal detachment in the left eye (arrow indicates, Panel 1a). After enlargement of axial T₁WI showed the "V sign" in the left eye was clearer (thick arrow indicates) and suspicious retinal detachment was visible in the right eye (thin arrow indicates, Panel 1b). Axial fat suppression FLAIR showed hyperintensity in bilateral medial temporal lobe, temporal extremely, and left temporal were obvious (arrows indicate, Panel 1c). Axial fat suppression FLAIR showed hyperintensity in bilateral insular cortex, anterior cingulate gyrus and basal ganglia (arrows indicate, Panel 1d).

图 2 眼底照相显示，右眼视网膜中央动脉堵塞、视盘苍白；左眼屈光介质混浊 OD，右眼；OS，左眼

Figure 2 Fundus photography showed the central retinal artery of the right eye was blocked and the optic disc was pale, while left eye dioptric media was cloudy.

图 3 眼底B超显示，双眼均存在视网膜脱离 OD，右眼；OS，左眼

Figure 3 Fundus B - ultrasonic examination showed retinal detachment in both eyes.

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Diagnosis and treatment of pseudorabies virus infectious encephalitis in human

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