Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81346, Taiwan.
J Microbiol Immunol Infect. 2009 Aug;42(4):296-302.
Japanese encephalitis virus infection is a sporadic infectious disease in Taiwan. Despite progress in laboratory examinations and imaging studies, diagnosis of Japanese encephalitis remains underestimated. This study was conducted to identify clinical symptoms and laboratory findings that may assist in early identification of this disease.
This retrospective study included all patients diagnosed with Japanese encephalitis at Kaohsiung Veterans General Hospital from January 2000 through December 2007. Epidemiologic data, predisposing factors, neurological and non-neurological signs and symptoms, laboratory data, and treatment were analyzed. Outcomes and neurological complications were evaluated.
Eleven patients had Japanese encephalitis, and 10 had sufficient information for enrolment into the study. Nine patients presented with non-significant constitutional symptoms of fever, nausea, or headache. Other signs and symptoms included rhinorrhea, sore throat, abdominal pain, cough, myalgia, or arthralgia. Eight patients had lymphocytic pleocytosis with elevated protein and borderline low glucose levels in the cerebrospinal fluid. Leptomeningeal enhancement and low density lesions were the most common computed tomography findings. T2 hyperintensity lesions and leptomeningeal enhancement were seen in 5 patients. Two patients presenting with acute flaccid paralysis had high intensity lesions on the thalamus and basal ganglion. There were no correlations between clinical, laboratory, and imaging findings. None of the patients had neurological sequelae.
Presentations, laboratory examination, and clinical signs are not specific for Japanese encephalitis. Sporadic cases are usually seen from May to August, which are associated with monsoon rains. Hence increased awareness of this disease is recommended during these periods.
在台湾，日本脑炎病毒感染是一种散发的传染病。尽管实验室检查和影像学研究取得了进展，但对日本脑炎的诊断仍被低估。本研究旨在确定可能有助于早期识别该疾病的临床症状和实验室发现。
本回顾性研究纳入了 2000 年 1 月至 2007 年 12 月期间在高雄荣民总医院诊断为日本脑炎的所有患者。分析了流行病学数据、易患因素、神经和非神经体征和症状、实验室数据以及治疗方法。评估了结局和神经并发症。
11 例患者患有日本脑炎，其中 10 例有足够的信息纳入研究。9 例患者出现非特异性全身症状，如发热、恶心或头痛。其他体征和症状包括流涕、咽痛、腹痛、咳嗽、肌痛或关节痛。8 例患者的脑脊液中存在淋巴细胞性白细胞增多症，伴有蛋白升高和边界性低血糖。最常见的计算机断层扫描结果是脑膜强化和低密度病变。5 例患者出现 T2 高信号病变和脑膜强化。2 例出现急性弛缓性瘫痪的患者丘脑和基底节有高强度病变。临床、实验室和影像学表现之间无相关性。无患者出现神经后遗症。
日本脑炎的临床表现、实验室检查和临床体征均不具特异性。散发病例通常见于 5 月至 8 月，与季风降雨有关。因此，建议在此期间提高对该病的认识。
