METHODS: Nationwide population-based cohort study of all adults hospitalised for viral lumbosacral radiculitis at departments of infectious diseases in Denmark from 2015 to 2020.
RESULTS: Twenty-eight patients with viral lumbosacral radiculitis were included (mean annual incidence: 1.2/1,000,000 adults). The median age was 35 years (IQR 27-43), and 22/28 (79%) were female. All patients had urinary retention, with 17/28 (61%) needing a catheter. On admission, at least one sign or symptom of meningitis (headache, neck stiffness, photophobia/hyperacusis) was present in 18/22 (82%). Concurrent genital herpetic lesions were present in 11/24 (46%). The median cerebrospinal fluid leukocyte count was 153 cells/µL (IQR 31-514). Magnetic resonance imaging showed radiculitis/myelitis in 5/19 (26%). The microbiological diagnosis was herpes simplex virus type 2 in 19/28 (68%), varicella-zoster virus in 2/28 (7%), and unidentified in 7/28 (25%). Aciclovir/valaciclovir was administered in 27/28 (96%). At 30 days after discharge, 3/27 (11%) had persistent urinary retention with need of catheter. At 180 days after discharge, moderate disabilities (Glasgow Outcome Scale score of 4) were observed in 5/25 (20%).
CONCLUSIONS: Urinary retention resolved within weeks in most patients with viral lumbosacral radiculitis, but moderate disabilities according to the Glasgow Outcome Scale were common at the end of follow-up.
方法:全国人群为基础的队列研究,调查了2015年至2020年丹麦感染病科所有因病毒性腰骶神经根炎住院的成年人。
结果:纳入28例病毒性腰骶部神经根炎患者(年平均发病率:1.2/1,000,000名成人)。中位年龄为35岁(IQR27-43),22/28(79%)为女性。所有患者都有尿潴留,17/28(61%)需要导管。一入场,脑膜炎的至少一种体征或症状(头痛,颈部僵硬度,畏光/高音)出现在18/22(82%)中。11/24(46%)存在并发生殖器疱疹性病变。脑脊液白细胞计数中位数为153个细胞/微升(IQR31-514)。磁共振成像显示神经根炎/脊髓炎在5/19(26%)。微生物学诊断为19/28(68%)的2型单纯疱疹病毒,水痘-带状疱疹病毒在2/28(7%),在7/28(25%)中身份不明。在27/28(96%)中施用了阿昔洛韦/伐昔洛韦。出院后30天,3/27(11%)持续尿潴留,需要导管。出院后180天,5/25(20%)观察到中度残疾(格拉斯哥预后量表得分为4分).
结论:大多数病毒性腰骶神经根炎患者的尿潴留可在数周内消退,但根据格拉斯哥结局量表,中度残疾在随访结束时很常见.