PDF(Pubmed)
Abstract：
A 34-year-old immunosuppressed male presented with worsening bilateral lower extremity weakness and urinary retention accompanied by a painless clean-based chancre on his glans penis. Physical examination revealed symmetrically diminished lower extremity weakness most pronounced with hip flexion and knee extension and absent Achilles reflexes. Full MRI spine without contrast was noncontributory. Lumbar puncture showed elevated protein and total nucleated cells with lymphocytic predominance. Both CSF and serum polymerase chain reaction were positive for herpes simplex virus type 2. He received IV methylprednisolone and acyclovir and underwent four months of physical therapy with complete resolution of his neurologic deficits.
摘要：
一名34岁的免疫抑制男性，表现为双侧下肢无力和尿retention留恶化，并伴有无痛的龟头下clean。体格检查显示下肢无力对称减少，最明显的是髋关节屈曲和膝关节伸展，并且跟腱反射缺失。无对比的全MRI脊柱是无贡献的。腰椎穿刺显示蛋白质和有核细胞总数升高，淋巴细胞占优势。脑脊液和血清聚合酶链反应对2型单纯疱疹病毒均呈阳性。他接受了静脉注射甲基强的松龙和阿昔洛韦，并接受了四个月的物理治疗，完全缓解了神经功能缺损。
