Meeuse J J, ter Borg F, Lohmann H J, Groen J
Afd. Interne Geneeskunde, Deventer Ziekenhuis, Postbus 5001, 7400 GC Deventer.
Ned Tijdschr Geneeskd. 2001 Oct 27;145(43):2084-6.
A 45-year-old patient was admitted with high fever and inadequate behaviour. She had recently stayed in Israel. Extensive investigation suggested a viral infection, but the cause was not established. Her partner suggested the possibility of West Nile virus infection, based upon information he had found on the Internet. Serology was performed and specific IgM and IgG antibodies were demonstrated, but a paired serum sample was not available. The patient recovered spontaneously. The West Nile virus is endemic in Israel, Africa, Asia and the Balkans. It is transmitted by mosquitoes. The incubation time is 1-3 weeks. The disease is characterised by fever, malaise, maculopapular exanthema and lymphadenopathy. Complications are encephalitis, pancreatitis, hepatitis and myocarditis. However, these symptoms are present in less than 5% of all infections. A full-blown encephalitis has a mortality rate of 50%. There is no specific therapy, but prevention by means of controlling the mosquito population is feasible. The diagnosis is made by the detection of West Nile virus-specific IgM antibodies in serum or cerebrospinal fluid. However, in the acute stage viral RNA detection by a polymerase chain reaction in the serum is also possible.
一名45岁患者因高热及行为异常入院。她近期去过以色列。全面检查提示病毒感染，但病因未明确。其伴侣根据在网上查到的信息，怀疑是西尼罗河病毒感染。进行了血清学检查，检测到特异性IgM和IgG抗体，但未获得双份血清样本。患者自行康复。西尼罗河病毒在以色列、非洲、亚洲及巴尔干半岛为地方性流行。它通过蚊子传播。潜伏期为1至3周。该病的特征为发热、不适、斑丘疹及淋巴结病。并发症有脑炎、胰腺炎、肝炎及心肌炎。然而，这些症状在所有感染中出现的比例不到5%。严重脑炎的死亡率为50%。没有特效治疗方法，但通过控制蚊虫数量进行预防是可行的。诊断通过检测血清或脑脊液中的西尼罗河病毒特异性IgM抗体来进行。不过，在急性期也可通过血清聚合酶链反应检测病毒RNA来诊断。
