Abstract：
The etiology of meningoencephalitis with COVID19 is coronavirus and herpetic. Secondary herpes infection is associated with immunological dysregulation or with the use of tocilizumab. Differential diagnosis of the etiology of encephalitis is important, because acyclovir is effective for herpes infection. Case Report: A 38-year-old man with right-sided lower lobe pneumonia COVID-19 was hospitalized in the infectious diseases department. On the 6th day of hospitalization, the patient developed respiratory failure and was transferred to the anesthesiology and intensive care unit. We started noninvasive lung ventilation, which was ineffective, and the patient was intubated and started on MVL. MRI data: encephalitis of the frontal, parietal and occipital lobes on the left. On the 14th day, we detected a herpetic rash on the legs and thighs in the projection of the sciatic nerve. We suspected the patient had a herpes infection and prescribed acyclovir 1000 mg intravenously 3 times a day. On the 32nd day, a blood test by IFA revealed class G antibodies to the Viral Capsid Antigen (VCA) of the Epstein-Barr virus. On the 58th day, he was discharged home in a satisfactory condition. Given the extraordinary strain on healthcare systems amid the pandemic, there are challenges in diagnosing herpes infection in patients with COVID-19. The alertness of doctors about the development of herpes infection and its clinical signs is important. This will allow for early antiherpetic treatment.
摘要：
患有COVID19的脑膜脑炎的病因是冠状病毒和疱疹。继发性疱疹感染与免疫失调或使用托珠单抗有关。鉴别诊断脑炎的病因很重要，因为阿昔洛韦对疱疹感染有效。病例报告：1名38岁男子右侧下叶肺炎COVID-19在传染病科住院。住院第6天,患者出现呼吸衰竭,转入麻醉科和重症监护室.我们开始无创肺通气,这是无效的，患者已插管并开始接受MVL治疗。MRI数据：额叶脑炎，左侧的顶叶和枕叶。第14天,我们在坐骨神经的投影中发现了腿和大腿上的疱疹性皮疹。我们怀疑该患者患有疱疹感染，并每天3次静脉注射阿昔洛韦1000mg。在第32天,IFA的血液测试显示针对爱泼斯坦-巴尔病毒的病毒衣壳抗原（VCA）的G类抗体。第58天,他在令人满意的情况下出院回家。鉴于大流行期间医疗保健系统面临的巨大压力，在诊断COVID-19患者的疱疹感染方面存在挑战。医生对疱疹感染的发展及其临床症状的警觉性很重要。这将允许早期抗疱疹治疗。
