Fabrizius Ryan G, Anderson Kathryn, Hendel-Paterson Brett, Kaiser Robyn M, Maalim Salahudin, Walker Patricia F
Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences of the Walter Reed Army Institute of Research, Bangkok, Thailand.
Am J Trop Med Hyg. 2016 Nov 2;95(5):1161-1165. doi: 10.4269/ajtmh.16-0397. Epub 2016 Oct 17.
Zika virus (ZIKV) is a mosquito-borne flavivirus with a significant public health impact highlighted by the ongoing epidemic in the Americas. We describe a 44-year-old male presenting to our tropical medicine center with complaints of fever, headache, joint pain, and rash after recent travel to Guyana. The patient subsequently developed gait imbalance and lower extremity weakness with clinical examination, cerebrospinal fluid studies, and magnetic resonance imaging of the spine consistent with a diagnosis of Guillain-Barré syndrome (GBS). ZIKV infection was confirmed via detection of ZIKV RNA in urine by polymerase chain reaction. The patient was treated with intravenous immunoglobulin and experienced near-complete neurologic recovery, reporting ongoing mild paresthesia up to 2 months later. This case highlights the diagnostic challenges posed by ZIKV and underscores the need for clinician awareness of the potential for neurological complications such as GBS with ZIKV infection.
寨卡病毒（ZIKV）是一种通过蚊子传播的黄病毒，其对公共卫生具有重大影响，美洲地区的持续疫情凸显了这一点。我们描述了一名44岁男性，他近期前往圭亚那旅行后，因发热、头痛、关节疼痛和皮疹前来我们的热带医学中心就诊。随后，该患者出现步态失衡和下肢无力，临床检查、脑脊液研究以及脊柱磁共振成像结果均符合吉兰-巴雷综合征（GBS）的诊断。通过聚合酶链反应检测尿液中的寨卡病毒RNA，确诊为寨卡病毒感染。该患者接受了静脉注射免疫球蛋白治疗，神经功能几乎完全恢复，直至2个月后仍报告有持续的轻度感觉异常。该病例突出了寨卡病毒带来的诊断挑战，并强调临床医生需要意识到寨卡病毒感染可能引发诸如吉兰-巴雷综合征等神经系统并发症。
