PDF(Pubmed)
Abstract：
BACKGROUND: Pseudorabies virus (PRV) was thought to only infect animals. Recent studies have shown that it can also infect human.
METHODS: We report a case of pseudorabies virus encephalitis and endophthalmitis, diagnosed 89 days after onset, confirmed with intraocular fluid metagenomic next generation sequencing (mNGS) after the result of two cerebrospinal fluid (CSF) mNGS tests were negative. Although treatment with intravenous acyclovir, foscarnet sodium, and methylprednisolone improved the symptoms of encephalitis, significant diagnostic delay resulted in permanent visual loss.
CONCLUSIONS: This case suggests that pseudorabies virus (PRV) DNA in the intraocular fluid may have a higher positivity than that in the CSF. PRV may persist in the intraocular fluid for an extended period and may thus require extended antiviral therapy. Patients with severe encephalitis and PRV should be examined with the focus on pupil reactivity and light reflex. A fundus examination should be performed in patients with a central nervous system infection, specifically, those in a comatose state, to help reduce eye disability.
METHODS: We report a case of pseudorabies virus encephalitis and endophthalmitis, diagnosed 89 days after onset, confirmed with intraocular fluid metagenomic next generation sequencing (mNGS) after the result of two cerebrospinal fluid (CSF) mNGS tests were negative. Although treatment with intravenous acyclovir, foscarnet sodium, and methylprednisolone improved the symptoms of encephalitis, significant diagnostic delay resulted in permanent visual loss.
CONCLUSIONS: This case suggests that pseudorabies virus (PRV) DNA in the intraocular fluid may have a higher positivity than that in the CSF. PRV may persist in the intraocular fluid for an extended period and may thus require extended antiviral therapy. Patients with severe encephalitis and PRV should be examined with the focus on pupil reactivity and light reflex. A fundus examination should be performed in patients with a central nervous system infection, specifically, those in a comatose state, to help reduce eye disability.
摘要：
背景：伪狂犬病病毒（PRV）被认为仅感染动物。最近的研究表明，它也可以感染人类。
方法：我们报告一例伪狂犬病病毒脑炎和眼内炎，发病89天后确诊，经眼内液宏基因组下一代测序（mNGS）证实，两次脑脊液（CSF）mNGS检测结果均为阴性。虽然静脉注射阿昔洛韦治疗，膦甲酸钠,甲基强的松龙改善了脑炎的症状，显著的诊断延迟导致永久性视力丧失.
结论：此病例提示眼内液体中的伪狂犬病病毒（PRV）DNA可能比CSF中的阳性更高。PRV可能会在眼内液中持续较长时间，因此可能需要长期的抗病毒治疗。严重脑炎和PRV患者应重点检查瞳孔反应性和光反射。中枢神经系统感染患者应进行眼底检查，具体来说,那些处于昏迷状态的人，帮助减少眼部残疾。
方法：我们报告一例伪狂犬病病毒脑炎和眼内炎，发病89天后确诊，经眼内液宏基因组下一代测序（mNGS）证实，两次脑脊液（CSF）mNGS检测结果均为阴性。虽然静脉注射阿昔洛韦治疗，膦甲酸钠,甲基强的松龙改善了脑炎的症状，显著的诊断延迟导致永久性视力丧失.
结论：此病例提示眼内液体中的伪狂犬病病毒（PRV）DNA可能比CSF中的阳性更高。PRV可能会在眼内液中持续较长时间，因此可能需要长期的抗病毒治疗。严重脑炎和PRV患者应重点检查瞳孔反应性和光反射。中枢神经系统感染患者应进行眼底检查，具体来说,那些处于昏迷状态的人，帮助减少眼部残疾。
