Wang H S, Huang S C
Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
J Child Neurol. 1993 Oct;8(4):378-82. doi: 10.1177/088307389300800416.
Early antiviral treatment is important for herpes simplex encephalitis. A reliable test for supporting empirical therapy with antiviral agents is urgently needed. Sixty-six children with fever, focal seizures, and consciousness disturbance had their sera examined for anti-herpes simplex viral immunoglobulin M (IgM) antibody with enzyme-linked immunosorbent assay. The result was positive in all seven patients confirmed to have herpes simplex encephalitis. Only two of the other 59 patients were positive on this test. The average period for the development of serologic positivity was 7.3 days from the onset of neurologic symptoms. Although most sera were not tested in the early stage, all were collected on admission day. Our data suggest that before further evidence indicates another diagnosis, this simple, but specific IgM antibody test could be used as a guide for deciding to continue the antiviral treatment for serologically positive cases or to discontinue antiviral treatment for serologically negative ones. Yet, we would not suggest diagnosing herpes simplex encephalitis with this test alone.
早期抗病毒治疗对于单纯疱疹性脑炎很重要。迫切需要一种可靠的检测方法来支持抗病毒药物的经验性治疗。对66例有发热、局灶性癫痫发作和意识障碍的儿童进行血清检测，采用酶联免疫吸附试验检测抗单纯疱疹病毒免疫球蛋白M（IgM）抗体。在所有确诊为单纯疱疹性脑炎的7例患者中，结果均为阳性。其他59例患者中只有2例此项检测呈阳性。血清学阳性出现的平均时间为神经系统症状出现后7.3天。尽管大多数血清在早期未进行检测，但所有血清均在入院当天采集。我们的数据表明，在有进一步证据提示其他诊断之前，这种简单但特异的IgM抗体检测可作为指导，用于决定对血清学阳性病例继续进行抗病毒治疗，或对血清学阴性病例停止抗病毒治疗。然而，我们不建议仅通过此项检测来诊断单纯疱疹性脑炎。
