Saliba W R, Raz R, Keness Y, Goldstein L H, Reshef A, Elias M
Department of Internal Medicine C, Haemek Medical Center, Afula, 18101, Israel.
Eur J Clin Microbiol Infect Dis. 2004 Jul;23(7):563-6. doi: 10.1007/s10096-004-1166-9. Epub 2004 Jun 25.
Presented here is the case of an immunocompetent pregnant woman with probable cytomegalovirus encephalitis. The clinical picture was characterized by diffuse headache, drowsiness and the development of an acute confused state. Diagnosis was based on the documentation of recent cytomegalovirus seroconversion with low avidity for the immunoglobulin G class antibodies. Initially, the diagnosis of encephalitis was challenging due to the subtle findings in cerebrospinal fluid and the normal electroencephalograph results. However, repeated tests revealed findings compatible with the diagnosis of encephalitis. Due to the suspicion of herpes simplex encephalitis the patient was treated with acyclovir. Within a few days rapid resolution of the fever and complete recovery were observed. Cytomegalovirus encephalitis should be considered early in the evaluation of pregnant women if appropriate clinical symptoms are present.
本文介绍了一例免疫功能正常的孕妇可能患有巨细胞病毒性脑炎的病例。临床表现为弥漫性头痛、嗜睡以及急性意识模糊状态的出现。诊断依据是近期巨细胞病毒血清学转换的记录,其针对免疫球蛋白G类抗体的亲和力较低。最初,由于脑脊液检查结果不明显且脑电图结果正常,脑炎的诊断颇具挑战性。然而,重复检查发现了与脑炎诊断相符的结果。由于怀疑为单纯疱疹病毒性脑炎,患者接受了阿昔洛韦治疗。数天内观察到发热迅速消退且完全康复。如果孕妇出现适当的临床症状,在评估时应尽早考虑巨细胞病毒性脑炎。