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拉沙热脑病:脑脊液中存在拉沙病毒,但血清中未检测到。

Lassa fever encephalopathy: Lassa virus in cerebrospinal fluid but not in serum.

作者信息

Günther S, Weisner B, Roth A, Grewing T, Asper M, Drosten C, Emmerich P, Petersen J, Wilczek M, Schmitz H

机构信息

Bernhard-Nocht-Institut für Tropenmedizin, D-20359 Hamburg, Germany.

出版信息

J Infect Dis. 2001 Aug 1;184(3):345-9. doi: 10.1086/322033. Epub 2001 Jul 3.

Abstract

The pathogenesis of neurologic complications of Lassa fever is poorly understood. A Nigerian patient had fever, disorientation, seizures, and blood-brain barrier dysfunction, and Lassa virus was found in cerebrospinal fluid (CSF) but not in serum. The concentration of Lassa virus RNA in CSF corresponded to 1 x 10(3) pfu/mL, as determined by a quantitative real-time polymerase chain reaction assay. To characterize the Lassa virus in CSF, the 3.5-kb S RNA was sequenced. In the S RNA coding sequences, the CSF strain differed between 20% and 24.6% from all known prototype strains. These data suggest that Lassa virus or specific Lassa virus strains can persist in the central nervous system and thus contribute to neuropathogenesis. Lassa virus infection should be considered in West African patients or in travelers returning from this area who present only with fever and neurologic signs.

摘要

拉沙热神经并发症的发病机制尚不清楚。一名尼日利亚患者出现发热、定向障碍、癫痫发作和血脑屏障功能障碍,脑脊液(CSF)中发现拉沙病毒,但血清中未发现。通过定量实时聚合酶链反应测定,脑脊液中拉沙病毒RNA的浓度相当于1×10(3) pfu/mL。为了鉴定脑脊液中的拉沙病毒,对3.5kb的S RNA进行了测序。在S RNA编码序列中,脑脊液毒株与所有已知原型毒株的差异在20%至24.6%之间。这些数据表明,拉沙病毒或特定的拉沙病毒毒株可在中枢神经系统中持续存在,从而导致神经发病机制。对于仅出现发热和神经体征的西非患者或从该地区返回的旅行者,应考虑拉沙病毒感染。

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