Ginanneschi Federica, Donati Donatella, Moschettini Donatella, Dominici Federica, Cermelli Claudio, Rossi Alessandro
Department of Neurological and Behavioural Sciences, Unit of Clinical Neurophysiology, University of Siena, Policlinico Le Scotte,Viale Bracci, 2, 53100 Siena, Italy.
Clin Neurol Neurosurg. 2007 Apr;109(3):272-6. doi: 10.1016/j.clineuro.2006.04.002. Epub 2006 May 19.
An active co-infection with CMV and HHV-7 has been never described in immunocompetent patients. The authors describe a case of encephaloradiculomyelitis in an immunocompetent man. Polymerase chain reaction (PCR) performed on cerebrospinal fluid (CSF) showed positivity for DNA of Cytomegalovirus (CMV) and Herpes-virus type 7 (HHV-7), whereas the same test applied on peripheral blood mononuclear cells gave negative result. These results are highly supportive of an infection of the central and peripheral nervous systems, caused by CMV and HHV7. Such viral co-infection has only been described in immune-depressed patients with CMV disease, in which HHV-7 was supposed to act as a cofactor, enhancing clinical manifestations. The same mechanism is presumably responsible for the development of encephaloradiculomyelitis clinical signs in the present case. This is the second case in which DNA of HHV-7 has been found in the CSF of an adult immunocompetent patient. This novel observation suggests that the search for viral DNA in the CSF should be performed also in immunocompetent patients.
免疫功能正常的患者中从未有过巨细胞病毒（CMV）和人疱疹病毒7型（HHV - 7）合并感染的报道。作者描述了一例免疫功能正常男性发生脑脊髓神经根炎的病例。对脑脊液（CSF）进行的聚合酶链反应（PCR）显示，巨细胞病毒（CMV）和7型疱疹病毒（HHV - 7）的DNA呈阳性，而对外周血单核细胞进行同样检测结果为阴性。这些结果高度支持由CMV和HHV - 7引起的中枢和外周神经系统感染。这种病毒合并感染仅在患有CMV疾病的免疫抑制患者中被描述过，其中HHV - 7被认为是一种辅助因子，会加重临床表现。推测同样的机制导致了本例脑脊髓神经根炎临床症状的出现。这是第二例在免疫功能正常的成年患者脑脊液中发现HHV - 7 DNA的病例。这一新发现表明，对免疫功能正常的患者也应进行脑脊液中病毒DNA的检测。
