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一名老年成人脑脊液中存在病毒RNA的甲型H3N2流感相关性脑膜脑炎:病例报告

Influenza A H3N2-Associated Meningoencephalitis in an Older Adult With Viral RNA in Cerebrospinal Fluid: Case Report.

作者信息

Dou Yu-Chao, Li Yu-Qing

机构信息

Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.

出版信息

Front Neurol. 2022 Apr 25;13:874078. doi: 10.3389/fneur.2022.874078. eCollection 2022.

Abstract

Influenza-associated encephalopathy (IAE) is most frequently observed in young children, but less reported in adults. Diagnosis of IAE is difficult, as clinical presentations vary significantly and the influenza virus is rarely detected in cerebrospinal fluid (CSF). Herein, we described the case of an older adult presenting with acute meningoencephalitis due to an influenza A (H3N2) infection and the influenza A (H3N2) RNA is detected in cerebrospinal fluid. To the best of our knowledge, this is infrequently reported in the literature. We emphasize that, in adults presenting with acute viral encephalitis, clinicians should consider an influenza infection as part of the differential diagnosis and that metagenomic next-generation sequencing of CSF for IAE may help establish an accurate diagnosis. It must be emphasized that the administration of steroids in a timely manner following the onset of symptoms may yield a better outcome in patients.

摘要

流感相关性脑病(IAE)在幼儿中最为常见,但在成人中报道较少。IAE的诊断较为困难,因为临床表现差异很大,且在脑脊液(CSF)中很少检测到流感病毒。在此,我们描述了一例因甲型(H3N2)流感感染而出现急性脑膜脑炎的老年患者病例,并在脑脊液中检测到甲型(H3N2)流感RNA。据我们所知,这在文献中鲜有报道。我们强调,对于出现急性病毒性脑炎的成人,临床医生应将流感感染作为鉴别诊断的一部分考虑,并且对CSF进行宏基因组下一代测序以诊断IAE可能有助于准确诊断。必须强调的是,症状出现后及时给予类固醇治疗可能会使患者获得更好的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86aa/9082942/bf975b33c48d/fneur-13-874078-g0001.jpg

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