Avkan Oğuz Vildan, Yapar Nur, Sezak Nurbanu, Alp Cavuş Sema, Kuruüzüm Ziya, Sayiner Arzu, Ada Emel, Cakir Nedim, Yüce Ayşe
Dokuz Eylül Universitesi Tip Fakültesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, Izmir.
Mikrobiyol Bul. 2006 Jan-Apr;40(1-2):93-8.
In this report, characteristics of two cases of Herpes simplex virus (HSV) encephalitis with normal cerebrospinal fluid (CSF) findings at the time of admission have been discussed and the current literature has been reviewed. The diagnosis of the cases (one was 23 years old male, and the other was 75 years old female patient) was made on the magnetic resonance imaging (MRI) findings concordant with HSV encephalitis, together with HSV-1 DNA positivity by polymerase chain reaction (PCR). Both of the patients were treated with acyclovir (3 x 750 mg/day) lasting for 15 days and 21 days, respectively. The first male patient recovered with mild neurological defects, whereas the second female patient died because of nosocomial pneumonia and septicemia. In conclusion, even the CSF findings are normal, in cases considered to be HSV encephalitis, MRI should be the first radiological diagnostic step and the diagnosis should be confirmed by the detection of HSV DNA in CSF by PCR.
在本报告中，我们讨论了两例入院时脑脊液（CSF）检查结果正常的单纯疱疹病毒（HSV）脑炎病例的特征，并回顾了当前的文献。这两例病例（一例为23岁男性，另一例为75岁女性患者）根据与HSV脑炎相符的磁共振成像（MRI）结果以及聚合酶链反应（PCR）检测到的HSV-1 DNA阳性得以确诊。两名患者均接受了阿昔洛韦治疗（3×750毫克/天），分别持续15天和21天。第一名男性患者康复，但遗留轻度神经功能缺损，而第二名女性患者因医院获得性肺炎和败血症死亡。总之，即使CSF检查结果正常，对于疑似HSV脑炎的病例，MRI应作为首要的影像学诊断步骤，且应通过PCR检测CSF中的HSV DNA来确诊。
