Sauerbrei A, Pawlak J, Luger C, Wutzler P
Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of Jena, Germany.
Dev Med Child Neurol. 2003 Dec;45(12):837-40. doi: 10.1017/s0012162203001555.
Patients with congenital varicella syndrome (CVS) typically present with clinical symptoms consisting of skin lesions, neurological defects, eye diseases, and/or limb hypoplasia. In rare cases, isolated manifestations in the brain or eye have been reported. The varicella-zoster virus (VZV), as the causative agent of CVS, could only be detected in a few infants with CVS. In addition, there is little in the literature on antiviral treatment of infants born with signs of CVS. We report a case of CVS in a male infant who presented with generalized clonic cerebral seizures at age 4 months. An endogenous intracerebral viral reactivation following intrauterine VZV infection was assumed. After the diagnosis was confirmed virologically, acyclovir was administered intravenously for 10 days and afterwards orally for 3 weeks. This antiviral treatment was aimed at preventing progression of the disease. We concluded from this case that infants with intrauterine VZV infection can suffer intracerebral VZV reactivations that require antiviral treatment.
先天性水痘综合征(CVS)患者通常表现出由皮肤病变、神经缺陷、眼部疾病和/或肢体发育不全组成的临床症状。在罕见情况下,曾有脑部或眼部孤立表现的报道。水痘-带状疱疹病毒(VZV)作为CVS的病原体,仅在少数CVS婴儿中被检测到。此外,关于出生时伴有CVS体征的婴儿抗病毒治疗的文献很少。我们报告一例男性婴儿CVS病例,该婴儿在4个月大时出现全身性阵挛性脑癫痫发作。推测为宫内VZV感染后内源性脑内病毒再激活。病毒学确诊后,静脉给予阿昔洛韦10天,之后口服3周。这种抗病毒治疗旨在预防疾病进展。我们从该病例得出结论,宫内VZV感染的婴儿可发生脑内VZV再激活,需要进行抗病毒治疗。