Yang C H, Yiang T G, Peng M Y, Hsu G J
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Apr;53(4):253-6.
Varicella (chickenpox) is the primary infection of Varicella-Zoster virus, characterized by generalized vesicular eruption, fever and mild constitutional symptoms. Chiefly infecting children of 1 to 14 years of age, the disease has been almost neglected because of its inevitable and benign outcome. Adults are rarely infected with an incidence of less than 20%. These two cases are presented of normal adults with marked neurological complications 10 and 14 days, respectively, following typical skin eruption of varicella. The first case developed transverse myelitis and the second, an encephalomyelitis. Neurological complications are very rare post-varicella infection. Although prognosis is good and complete recovery is the rule, still some morbidity with neurological sequelae and mortality have been reported. The present cases had extensive neurological deficit, despite aggressive treatment, making a high index of suspicion for differential diagnosis in patients who present with encephalitis. Especially following the typical exanthema of varicella, this possibility is emphasized and the literature is reviewed.
水痘是由水痘-带状疱疹病毒引起的原发性感染,其特征为全身性水疱疹、发热及轻微的全身症状。该疾病主要感染1至14岁的儿童,由于其不可避免且预后良好,几乎一直被忽视。成人很少感染,发病率低于20%。本文介绍了两例正常成人病例,分别在水痘典型皮疹出现后10天和14天出现明显的神经并发症。第一例发生了横贯性脊髓炎,第二例发生了脑脊髓炎。水痘感染后神经并发症非常罕见。尽管预后良好且通常能完全康复,但仍有一些伴有神经后遗症的发病情况及死亡病例的报道。尽管进行了积极治疗,目前这两例患者仍有广泛的神经功能缺损,这使得对于出现脑炎症状的患者在鉴别诊断时需高度怀疑。特别是在水痘典型皮疹出现后,这种可能性应受到重视,并对相关文献进行了综述。