Opitz J C, Kettrick M A, Sullivan B J
Department of Pediatrics, Marshfield Clinic, Wisconsin 54449.
Am J Perinatol. 1989 Jul;6(3):307-9. doi: 10.1055/s-2007-999599.
This report describes a newborn with recurrent herpes simplex meningoencephalitis despite vigorous antiviral therapy. The course is unusual in that the presenting symptom was hoarseness. Despite probable adequate acyclovir levels in the spinal fluid, a second episode or progression of herpetic encephalitis occurred, suggesting impairment of host defenses, particularly cellular immunity. This episode was treated with both acyclovir and vidarabine. Pharmacokinetics of the antiviral therapy and immune responses are discussed.
本报告描述了一名新生儿，尽管接受了积极的抗病毒治疗，仍反复发生单纯疱疹性脑膜脑炎。病程不同寻常之处在于首发症状为声音嘶哑。尽管脑脊液中阿昔洛韦水平可能足够，但疱疹性脑炎仍发生了第二次发作或病情进展，提示宿主防御功能受损，尤其是细胞免疫。此次发作同时使用了阿昔洛韦和阿糖腺苷进行治疗。文中讨论了抗病毒治疗的药代动力学及免疫反应。
