Tique Vaneza, Mattar Salim, Freire María, Illian Eduardo, Camargo Francisco, Vergara Oscar, Moraes-Figueiredo Luiz T
Universidad de Cordoba, Monteria, Colombia,
National Institute of Infectious Diseases, Buenos Aires, Argentina,
Rev Salud Publica (Bogota). 2016 Aug;18(4):581-591. doi: 10.15446/rsap.v18n4.47517.
Objective To establish an epidemiological surveillance of viral herpes encephalitis in major hospitals of Monteria, Cordoba. Methods From September 2009 to December 2011, a descriptive study of cases of viral encephalitis was made in three hospitals in the city of Monteria. Cerebrospinal fluid (CSF) samples from 118 patients were included in the study. Clinical aspects, as well as cytochemical and microbiological analysis (Gram stain and culture) of CSF, were used for selecting the patients. Virus detection was performed by using multiplex nested PCR for Herpes simplex virus 1 and 2, Epstein Barr virus, Cytomegalovirus and Varicella zoster virus. Results Viral DNA of herpesvirus was detected in the CSFs of 30 (25.4 %) participants, as follows: 22 (18.6 %) Herpes simplex 1 and 2 viruses, 4 (3.3 %) Cytomegalovirus and 1 (0.8 %) Varicella zoster virus. Co-infections were observed in 3 patients (2.5 %), 1 case by HSV-VZV and 2 cases by CMV/HSV. The clinical manifestations of the patients included: headache (18.6 %), fever (14.4 %), asthenia (10.1 %), seizures (9.3 %), vomiting (8.4 %), and stiff neck (5.9 %). Thirty percent of the patients also had HIV-AIDS. A case fatality rate of 20 % was observed for the patients. Conclusions This paper shows that herpesvirus is a cause of infection of the CNS in patients from Cordoba. This study contributes to the epidemiology of encephalitis, as well as to patient management.
目的 在科尔多瓦省蒙特里亚市的主要医院建立病毒性疱疹性脑炎的流行病学监测。方法 2009年9月至2011年12月,对蒙特里亚市三家医院的病毒性脑炎病例进行描述性研究。研究纳入了118例患者的脑脊液样本。通过临床症状以及脑脊液的细胞化学和微生物学分析(革兰氏染色和培养)来选择患者。采用多重巢式PCR检测单纯疱疹病毒1型和2型、EB病毒、巨细胞病毒和水痘带状疱疹病毒以进行病毒检测。结果 在30名(25.4%)参与者的脑脊液中检测到疱疹病毒的病毒DNA,具体如下:22名(18.6%)单纯疱疹病毒1型和2型,4名(3.3%)巨细胞病毒,1名(0.8%)水痘带状疱疹病毒。在3名患者(2.5%)中观察到合并感染,1例为HSV-VZV合并感染,2例为CMV/HSV合并感染。患者的临床表现包括:头痛(18.6%)、发热(14.4%)、乏力(10.1%)、癫痫发作(9.3%)、呕吐(8.4%)和颈部僵硬(5.9%)。30%的患者还患有艾滋病毒-艾滋病。观察到患者的病死率为20%。结论 本文表明疱疹病毒是科尔多瓦省患者中枢神经系统感染的病因之一。本研究有助于脑炎的流行病学研究以及患者管理。