Roine R O, Hillbom M, Valle M, Haltia M, Ketonen L, Neuvonen E, Lumio J, Lähdevirta J
Department of Neurology, University of Helsinki, Finland.
Brain. 1988 Dec;111 ( Pt 6):1505-16. doi: 10.1093/brain/111.6.1505.
The clinical findings are described in the first reported European case of fatal encephalitis of bat origin caused by a rabies-related virus. A bat zoologist developed the symptoms of rabies 51 days after his last exposure to a bat bite. The clinical disease of 23 days duration was a combination of the paralytic and 'furious' forms of rabies. Serial BAEP and EEG recordings, CT and MR scans of the brain, as well as CSF findings, demonstrated severe ascending destruction of the brain. An unusual progression from isolated brainstem death to cortical brain death occurred. Neuropathologically, the brain showed severe lytic changes. The presence of rabies-related virus antigens in brain smears was shown using a panel of fluorescent antibodies. The virus was inoculated into and isolated from suckling mice. The virus had a close resemblance to European bat rabies isolates, which belong to the group of rabies-related viruses. Of particular concern is whether the virus can spread from bats to terrestrial animals and whether the European type of bat rabies constitutes a danger to man.
本文描述了欧洲首例由狂犬病相关病毒引起的蝙蝠源性致命脑炎的临床发现。一名蝙蝠动物学家在最后一次接触蝙蝠咬伤51天后出现狂犬病症状。持续23天的临床疾病表现为麻痹型和“狂暴”型狂犬病的结合。连续的脑干听觉诱发电位（BAEP）和脑电图（EEG）记录、脑部CT和磁共振成像（MR）扫描以及脑脊液检查结果显示，脑部存在严重的上行性破坏。出现了从孤立的脑干死亡到皮质脑死亡的异常进展。神经病理学检查显示，脑部有严重的溶解变化。使用一组荧光抗体在脑涂片上显示了狂犬病相关病毒抗原的存在。该病毒接种到乳鼠体内并从中分离出来。该病毒与欧洲蝙蝠狂犬病分离株非常相似，这些分离株属于狂犬病相关病毒组。特别令人担忧的是，该病毒是否能从蝙蝠传播到陆生动物，以及欧洲类型的蝙蝠狂犬病是否对人类构成危险。
