Abstract：
A man, 26years-old, presented fever, mental confusion and a progressively worsening headache 6days prior to admission. The CSF study was suggestive of meningoencephalitis, the PCR study revealed presence of HSV-1 and ZIKV, while other immunology tests were negative. ZIKV was also identified in serum. The MRI showed temporal lobe hyper-intensity in FLAIR-weight sequence with areas of contrast enhancement and the electroencephalogram showed slow wave activity in such region. Patient was treated with acyclovir and supportive measures and had good clinical outcome at evaluation after 6 months. Neurological spectrum of ZIKV manifestations is wide, but meningoencephalitis is not frequent. Co-infection HSV-1 plus ZIKV was not yet related in humans, but there is increased cellular damage caused by association of ZIKV and herpes virus family infection. ZIKV may facilitate infection or recrudescence by other viruses or cause concurrently neuronal injury by direct or indirect mechanisms. We suggest that clinicians attempt new manifestations related to ZIKV and include this agent in differential diagnosis of neurological diseases even when other agents were identified.
摘要：
一个男人,26岁,发烧，入院前6天精神错乱和逐渐恶化的头痛。CSF研究提示脑膜脑炎，PCR研究显示存在HSV-1和ZIKV，而其他免疫学检查均为阴性。ZIKV也在血清中鉴定。MRI显示FLAIR权重序列中的颞叶高强度增强，具有对比度增强区域，脑电图显示该区域的慢波活动。患者接受阿昔洛韦和支持措施治疗，6个月后评估时具有良好的临床结果。ZIKV表现的神经范围很广，但是脑膜脑炎并不常见。在人类中，合并感染HSV-1加ZIKV尚未相关，但是ZIKV和疱疹病毒家族感染的关联引起的细胞损伤增加。ZIKV可能促进其他病毒的感染或复发，或通过直接或间接机制同时引起神经元损伤。我们建议临床医生尝试与ZIKV相关的新表现，并将该药物纳入神经系统疾病的鉴别诊断中，即使确定了其他药物。
