Clinical phenotype analysis of varicella-zoster virus infection of the central nervous system
Objective Varicella-zoster virus(VZV)is the common causes of viral infection of the central nervous system(CNS),Its clinical manifestations are varied,Summary and analysis of its clinical manifestations and outcomes are helpful for early recognition,guidance of treatment and prognosis.Methods A retrospective analysis was performed for the 11 patients with CNS-VZV infection who were diagnosed and treated in Department of Neurology,Peking Union Medi-cal College Hospital,from 2014 to 2021 to analyze their clinical features and prognosis,and modified Rankin Scale(mRS)was used for evaluation.Results Among the 11 patients,there were 7 male patients(63.63%)and 4 female pa-tients(36.36%).As for clinical phenotypes,there were 4 patients with meningitis(36.36%),3 patients with limbic en-cephalitis(27.27%),3 patients with cerebral vasculitis(27.27%),and 1 patient with myelitis(9.09%).Three patients(27.27%)had acute rash of herpes zoster.The patients had a median cerebrospinal fluid(CSF)pressure of 165(85,330)mmH2O,a median CSF white blood cell count of 46(9,471)×106/L,a median CSF protein quantification of 0.85(0.32,3.12)g/L,and a CSF glucose level of 3.0(2.5,4.0)mmol/L.There was a significant change in mRS score after treatment[3(1,5)vs 0(0,6),P＜0.05].Conclusion The main clinical phenotypes of CSF-VZV infection include meningitis,limbic encephalitis,cerebral vasculitis,and myelitis,among which meningitis tends to have a good progno-sis,and the patients with immunosuppressive conditions tend to have a poor prognosis after VZV cerebral vasculitis.CSF mNGS is an important experiment for the confirmed diagnosis of VZV.
万方数据
维普
