疱疹病毒相关性脑炎：最新进展
Herpesvirus-Associated Encephalitis: an Update.
作者信息
Matthews Elizabeth, Beckham J David, Piquet Amanda L, Tyler Kenneth L, Chauhan Lakshmi, Pastula Daniel M
机构信息
Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado School of Medicine, 12700 E 19th Ave, Mailstop B-182, Aurora, CO 80045 USA.
Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO USA.
出版信息
Curr Trop Med Rep. 2022;9(3):92-100. doi: 10.1007/s40475-022-00255-8. Epub 2022 Sep 23.
PURPOSE OF REVIEW
Herpesviruses are a leading cause of encephalitis worldwide. The article reviews the eight human herpesviruses with a focus on recent advances as they pertain to encephalitis.
RECENT FINDINGS
Notable recent updates include the development of multiplex polymerase chain reaction (PCR)-based panels, which have improved access to PCR tests, especially in rural and resource-limited areas. Despite unchanged treatment recommendations, research is ongoing into novel therapies. There have been recent advances in vaccines, particularly for varicella zoster virus (VZV) which may impact neurologic complications. Finally, the recent discovery of an association between herpes encephalitis and post-infectious autoimmune encephalitis has had a critical impact on the fields of infectious and autoimmune neurology, though there remains much to learn.
SUMMARY
Most herpesviruses are neurotropic and must be considered on the differential diagnosis for infectious encephalitis. This article describes recent advances in the diagnosis, treatment, complications, and management of these infections.
综述目的
在全球范围内，疱疹病毒是引起脑炎的主要病因。本文回顾了八种人类疱疹病毒，重点关注与脑炎相关的最新进展。
最新发现
近期值得注意的进展包括基于多重聚合酶链反应（PCR）检测方法的开发，这改善了PCR检测的可及性，尤其是在农村和资源有限的地区。尽管治疗建议没有变化，但针对新型疗法的研究仍在进行。疫苗方面有了新进展，特别是针对水痘带状疱疹病毒（VZV）的疫苗，这可能会影响神经系统并发症。最后，近期发现疱疹性脑炎与感染后自身免疫性脑炎之间存在关联，这对感染性和自身免疫性神经病学领域产生了重大影响，不过仍有许多有待了解的地方。
总结
大多数疱疹病毒具有嗜神经性，在感染性脑炎的鉴别诊断中必须予以考虑。本文描述了这些感染在诊断、治疗、并发症及管理方面的最新进展。
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