Tässä artikkelissa kuvataan hyttysperäinen tauti Zikavirus -infektio, joka aiheutti 11 vuorokaudessa sairaalaan ottamisesta nuoren aikuisen aivokuoleman Artikkeli tuli PubMed hakuun tänä syksynä ja kertoo Brasilian tämän vuoden Zika-epidemian ensimmäisesta kuolonuhrista, 47 vuotiaasta naisesta, joka ei ollut raskaana. .
Naisella todettiin aivotulehdus, enkefaliitti, koska hän osoitti tajunnan tason muutoksia ja paikallisia neurologisia oireita exanthema-ihottumaa aiheuttaneen virustulehduksen aikana. Häneltä katsotiin likvor- analyysi ja siinä todettiin imusolujen pleosytoosia, korkeaa proteiinipitoisuutta ja IgM-luokan vasta-aineita Zikavirukselle. PCR-analyysissä oli zikavirus positiivinen virtsanäytteessä. Aivojen tietokonetomografiassa havaittiin massiivinen aivoturvotus. Tämä sairaustapaus erosi aiemmista neurologisten oireiden nopean pahenemisen ja hyvin aggressiivisen taudinkulun suhteen ja tila johti yhdentenätoista päivänä sairaalaan tulosta aivokuolemaan.
JOHTOPÄÄTÖS:Endeemisillä alueilla ZIKV pitäisi ottaa huomoon etiologisena tekijänä enkefaliittitapauksissa ja kliinikkojen tulisi olla tietoisia sen mahdollisesta vakavuudesta ( ilmeisesti kellä tahansa).
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J Clin Virol. 2016 Oct;83:63-5. doi: 10.1016/j.jcv.2016.08.297. Epub 2016 Aug 30.
Fatal encephalitis associated with Zika virus infection in an adult.
Soares CN1, Brasil P2, Carrera RM3, Sequeira P4, de Filippis AB4, Borges VA5, Theophilo F5, Ellul MA6, Solomon T6.
Zika
virus (ZIKV) was first identified in the Americas in 2015, when an
outbreak of an exanthematous illness occurred in Brazil. Subsequentely,
there was an increase of microcephaly cases, suggesting an association
between ZIKV and this neurological complication. Currently, ZIKV has
been recognised as causing a wide range of neurological complications
including Guillain Barré syndrome, and myelitis.
In this report, we describe the first fatal case of encephalitis in a 47 years old non pregnant woman, infected during the Brazilian zika epidemic of 2016.
The diagnosis of encephalitis was determined by the presence of a disturbed level of consciousness and focal neurological signs during an exanthemous viral infection.
CSF analysis supported the diagnosis of viral encephalitis, revealing lymphocytic pleocytosis, a high protein concentration, and the presence of IgM zika antibodies. RT-PCR analysis for ZIKV was positive in the urine. A brain computed tomography showed massive brain swelling. Our case differs from previous reports, because her neurological picture developed rapidly and in a very aggressive manner leading to brain death after eleven days of admission.
In this report, we describe the first fatal case of encephalitis in a 47 years old non pregnant woman, infected during the Brazilian zika epidemic of 2016.
The diagnosis of encephalitis was determined by the presence of a disturbed level of consciousness and focal neurological signs during an exanthemous viral infection.
CSF analysis supported the diagnosis of viral encephalitis, revealing lymphocytic pleocytosis, a high protein concentration, and the presence of IgM zika antibodies. RT-PCR analysis for ZIKV was positive in the urine. A brain computed tomography showed massive brain swelling. Our case differs from previous reports, because her neurological picture developed rapidly and in a very aggressive manner leading to brain death after eleven days of admission.
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