基孔肯雅热感染并发症之急性坏死性脑病
Acute Necrotizing Encephalopathy as a Complication of Chikungunya Infection.
作者信息
Holla V V, Gohel Abhishek B, Kartik N, Netravathi M
机构信息
Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru, Karnataka, India.
Department of Neuroimaging and Interventional Neuroradiology (NIIR), National Institute of Mental Health and Neurosciences (NIMHANS) Bengaluru, Karnataka, India.
出版信息
Neurol India. 2021 Mar-Apr;69(2):490-492. doi: 10.4103/0028-3886.314525.
BACKGROUND
Acute necrotizing encephalopathy (ANE) is a rapidly progressive encephalopathy seen commonly in children triggered by various prodromal viral infections, most common being influenza virus and Human herpes virus-6.
OBJECTIVE
We report two rare cases of ANE preceded by Chikungunya infection.
CASES
A 13-year old girl presented with a three-day history of headache, fever, seizures, and altered sensorium. Another 42-year old man presented with two days history of fever and altered sensorium. Both were suspected to have viral encephalitis. Evaluation revealed serum positivity for Chikungunya virus. In both cases, diagnosis was clinched by characteristic bilateral symmetrical thalamic lesions with central necrosis and hemorrhage along with lesions in cerebral white matter, brainstem, and cerebellum.
CONCLUSIONS
ANE is reported to have high morbidity and mortality. To the best of our knowledge, this is the first report of ANE post-Chikungunya infection. Apart from being rare etiologically, the patients had excellent response to steroids.
背景
急性坏死性脑病（ANE）是一种快速进展的脑病，常见于儿童，由各种前驱病毒感染引发，最常见的是流感病毒和人类疱疹病毒6型。
目的
我们报告两例罕见的由基孔肯雅热感染引发的急性坏死性脑病病例。
病例
一名13岁女孩出现头痛、发热、癫痫发作和意识改变，病程三天。另一名42岁男性出现发热和意识改变，病程两天。两人均怀疑患有病毒性脑炎。评估显示基孔肯雅病毒血清学阳性。两例病例均通过特征性的双侧对称性丘脑病变伴中央坏死和出血以及脑白质、脑干和小脑病变确诊。
结论
据报道，急性坏死性脑病的发病率和死亡率很高。据我们所知，这是首例关于基孔肯雅热感染后发生急性坏死性脑病的报告。除病因罕见外，患者对类固醇治疗反应良好。
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