Dyachenko Pavel A
Center of Infectious Disorders of the Nervous System, Si "L.V. Gromashevsky Institute of Epidemiology and Infection Diseases of Nams of Ukraine", KYIV, UKRAINE.
Wiad Lek. 2019;72(9 cz 2):1765-1768.
Introduction: Herpes zoster (HZ), or shingles, is localized disease characterized by unilateral radicular pain and a vesicular rash limited to the area of skin innervated by a single dorsal root or cranial sensory ganglion. Whereas varicella, or chickenpox, results from primary exogenous varicella-zoster virus (VZV) infection, HZ is caused by reactivation of endogenous VZV that has persisted in latent form within sensory ganglia following an earlier episode of chickenpox. The aim: To explore the clinical features, diagnosis, and treatment of CNS injury caused by VZV infection in a prospective single center study from January 2014 to January 2018.
Materials and methods: 117 adult patients, among which young women predominated with confirmed VZV infection were analyzed in the study. CSF and blood contents, antibody for herpes zoster M and G classes, and MRI scans have been studied, but the crucial diagnostic sign was the presence of specific viral DNA in the CSF or blood. The main clinical manifestations of the disease were ganglionitis and ganglioradiculoneuritis. Another brain lesion like uveitis, encephalitis and vasculitis were observed also. A clinical case of an unusual course of VZV-infection is given.
Results and conclusions: The most common clinical variants of HZ were ganglionitis (69.7%). Cranial localization was observed in 31% of patients, spinal one - in 38.7%, injury to the meninges was found in 16.3% of patients.
引言：带状疱疹（HZ），即缠腰龙，是一种局限性疾病，其特征为单侧神经根疼痛以及局限于由单个背根或颅感觉神经节支配的皮肤区域的水疱性皮疹。水痘是由原发性外源性水痘 - 带状疱疹病毒（VZV）感染引起的，而HZ是由内源性VZV重新激活所致，该病毒在先前一次水痘发作后以潜伏形式持续存在于感觉神经节内。目的：在一项2014年1月至2018年1月的前瞻性单中心研究中探讨VZV感染所致中枢神经系统损伤的临床特征、诊断及治疗方法。
材料与方法：本研究分析了117例确诊为VZV感染的成年患者，其中年轻女性居多。研究了脑脊液和血液成分、带状疱疹M和G类抗体以及磁共振成像扫描，但关键的诊断标志是脑脊液或血液中存在特异性病毒DNA。该疾病的主要临床表现为神经节炎和神经节神经根神经炎。还观察到了其他脑部病变，如葡萄膜炎、脑炎和血管炎。给出了1例VZV感染异常病程的临床病例。
结果与结论：HZ最常见的临床类型是神经节炎（69.7%）。31%的患者为颅部定位，38.7%为脊髓定位，16.3%的患者发现有脑膜损伤。
