Mateos V, Salas Puig J, Leiva P, Lahoz C H
Servicio de Neurología, Hospital General de Asturias, Oviedo.
Neurologia. 1992 Jan;7(1):30-3.
Q fever is a zoonosis found worldwide and is produced by Coxiella burnetii. It may be acute or chronic with neurological manifestations being infrequent. Several cases of acute encephalitis or meningoencephalitis have been described, generally with an evolution towards cure regardless of the use of selective antibiotic treatment. Recently the authors had the opportunity to study a 33 year old male presenting acute meningoencephalitis in which the clinical manifestations, CSF findings (increase in cellularity with lymphocytic predominance and excess proteins ) and neurophysiological findings (appearance of periodic bilateral complexes in the EEG) suggested the diagnosis of herpetic meningoencephalitis. Treatment with acyclovir was initiated. However, serologic studies demonstrated, a posteriori, that the germ responsible had been Coxiella burnetii. The patient evolved satisfactorily with no specific treatment and the EEG anomalies disappeared within a few days. The authors insist on the need to include Q Fever in the diagnostic differential of acute meningoencephalitis and emphasize the possibility that germs of a non viral nature may produce periodic EEG complexes in all that similar to those found in herpetic encephalitis.
Q热是一种在全球范围内发现的人畜共患病，由伯氏考克斯体引起。它可能是急性的或慢性的，神经系统表现并不常见。已经描述了几例急性脑炎或脑膜脑炎病例，通常无论是否使用选择性抗生素治疗，病情都有治愈的趋势。最近，作者有机会研究一名33岁的男性，他患有急性脑膜脑炎，其临床表现、脑脊液检查结果（细胞数增加，以淋巴细胞为主且蛋白质增多）和神经生理学检查结果（脑电图中出现周期性双侧复合波）提示为疱疹性脑膜脑炎。于是开始使用阿昔洛韦进行治疗。然而，血清学研究事后证明，致病病原体是伯氏考克斯体。该患者未经特殊治疗病情进展良好，脑电图异常在几天内消失。作者强调在急性脑膜脑炎的鉴别诊断中需要考虑Q热，并强调非病毒性质的病原体可能产生与疱疹性脑炎中发现的类似的周期性脑电图复合波的可能性。
