Fan Jennifer Nielsen, Fan Jerry, Ali Hameed
Department of Family Medicine, Baylor Scott & White Medical Center - Round Rock, Round Rock, Texas.
Department of Internal Medicine, Baylor Scott & White Medical Center - Temple, Temple, Texas.
Proc (Bayl Univ Med Cent). 2020 Jun 22;33(4):612-613. doi: 10.1080/08998280.2020.1775031.
This case describes a 60-year-old immunosuppressed man after renal transplant who presented to the emergency department with 1 week of generalized weakness, a 20-lb unintentional weight loss, sore throat, dysarthria, dysphagia, cough, and shortness of breath. Additionally, he developed tinnitus, headaches, photophobia, and neck stiffness. He underwent an extensive workup including a lumbar puncture with meningitis and encephalitis panel, which was positive for varicella zoster virus. He never developed a dermatomal vesicular rash but had persistent dysphagia and aspiration and was eventually diagnosed with Vernet syndrome. This case highlights theories for the increase in varicella zoster virus encephalitis cases causing neurologic symptoms and proposes that this trend is likely to continue.
该病例描述了一名60岁肾移植后免疫抑制的男性，他因1周的全身乏力、20磅非故意体重减轻、咽痛、构音障碍、吞咽困难、咳嗽和呼吸急促而就诊于急诊科。此外，他还出现了耳鸣、头痛、畏光和颈部僵硬。他接受了广泛的检查，包括腰椎穿刺及脑膜炎和脑炎相关检测，结果显示水痘带状疱疹病毒呈阳性。他从未出现过皮节性水疱疹，但持续存在吞咽困难和误吸，最终被诊断为韦内综合征。该病例突出了水痘带状疱疹病毒脑炎导致神经症状病例增加的相关理论，并提出这种趋势可能会持续。
