Chen Yanxiang, Dai Kai, Ruan Bofu, Wang Hui, Zhou Guonan, Jiang Ying
Department of Neurology, Xiaolan People's Hospital of ZhongShan (The Fifth People's Hospital of ZhongShan), 65#, Middle Section of Jucheng Avenue, Xiaolan, Zhongshan, Guangdong Province, 528400, China.
Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600# Tianhe Road, Guangzhou, Guangdong Province, 510630, China.
Heliyon. 2024 Oct 22;10(20):e39685. doi: 10.1016/j.heliyon.2024.e39685. eCollection 2024 Oct 30.
Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a mild encephalopathy, which may be associated with various pathogens, including virus and bacteria. However, there have been no reports on MERS associated with co-infection by respiratory syncytial virus (RSV) or in adults.
We reported a 29-year-old Chinese woman with MERS associated with RSV and . This woman presented with fever, sore throat, cough, and altered mental states. The results of RSV-RNA in the specimens from throat and sputum culture of were positive. The initial head CT scan on the day of admission revealed abnormal hypodense lesions in the suprasellar cistern (SCC). Subsequent brain magnetic resonance imaging (MRI) also demonstrated abnormal hypersignals in the same region. The patient's altered mental status improved on day after ceftriaxone and low-dose corticosteroid therapy. The SCC hypersignal on MRI completely resolved after three weeks, and no recurrence of symptoms occurred during the two-month follow-up period.
It is the first reported case of MERS associated with RSV and in the adult, which broadens the spectrum of potential etiologies in MERS. When a patient with a respiratory tract infection presents with neurological symptoms, the possibility of MERS should be considered.
临床轻度脑炎/脑病伴可逆性胼胝体压部病变(MERS)是一种轻度脑病,可能与多种病原体有关,包括病毒和细菌。然而,尚无关于成人中与呼吸道合胞病毒(RSV)合并感染相关的MERS的报道。
我们报告了一名29岁的中国女性,其MERS与RSV合并感染。该女性出现发热、咽痛、咳嗽和精神状态改变。咽喉和痰液培养标本中的RSV-RNA结果呈阳性。入院当天的初次头部CT扫描显示鞍上池(SCC)有异常低密度病变。随后的脑部磁共振成像(MRI)也显示同一区域有异常高信号。在头孢曲松和低剂量皮质类固醇治疗后,患者的精神状态改变在数天内有所改善。MRI上的SCC高信号在三周后完全消失,在两个月的随访期内未出现症状复发。
这是首次报道的成人中与RSV合并感染相关的MERS病例,拓宽了MERS潜在病因的范围。当呼吸道感染患者出现神经症状时,应考虑MERS的可能性。