Du Pasquier R, Meylan P, Kaiser L, Lalive P H
Département de médecine, CHUV, 1011 Lausanne.
Rev Med Suisse. 2009 Apr 29;5(201):968-70, 972-3.
Suspicion of viral encephalitis should always be considered as a medical emergency and the prognosis depend on both the immune status of the host and the virulence of the virus. Among them, the herpes simplex virus is by far the most important one since it can be associated with severe encephalitis in immunocompetent host, and because a good response to acyclovir can be expected when rapidly initiated. Nevertheless, confirmation of the diagnosis requires exclusion of both metabolic or toxic encephalopathy and inflammatory encephalitis of non-infectious origin. In addition, other germs than viruses can mimic viral encephalitis and must be taken into consideration. The purpose of this review is to update the investigation that should be performed in clinical practice for any patient with suspicion of acute viral encephalitis.
应始终将病毒性脑炎的怀疑视为医疗紧急情况,其预后取决于宿主的免疫状态和病毒的毒力。其中,单纯疱疹病毒是迄今为止最重要的一种,因为它可在免疫功能正常的宿主中引发严重脑炎,而且如果能迅速开始治疗,有望对阿昔洛韦产生良好反应。然而,确诊需要排除代谢性或中毒性脑病以及非感染性炎症性脑炎。此外,除病毒外的其他病原体也可模拟病毒性脑炎,必须予以考虑。本综述的目的是更新在临床实践中对任何疑似急性病毒性脑炎患者应进行的检查。