摘要
目的总结EB病毒感染侵犯小脑1例患儿的临床特征,复习EB病毒性脑炎的影像学改变。方法分析2020年12月苏州大学附属儿童医院收治的1例EB病毒侵犯小脑患儿的临床资料,同时复习EB病毒性脑炎影像学相关文献及损害小脑的病原学。结果1例既往健康的1岁2个月女童,根据其临床表现和脑脊液检查、脑脊液宏基因二代测序(mNGS)、影像学检查诊断为EB病毒性脑炎。送检mNGS结果显示外周血检测到EB病毒序列数6,脑脊液检测到EB病毒序列数4。患儿头颅磁共振成像(MRI)以小脑损害为主,治疗2周后病灶吸收,预后良好。结论EB病毒性脑炎起病急,临床表现与其他病毒性脑炎无明显特异性,大部分病灶累及灰质、基底节、深部白质等,少数侵犯小脑,影像学的改变对预后有一定的提示作用。侵犯小脑的病毒感染种类较多,在疾病早期,mNGS技术可对病原学诊断有一定的作用。
Objective To summarize the clinical features of a child with Epstein-Barr(EB)virus infection invading the cerebellum,and review the imaging changes of EB virus encephalitis.Methods The clinical data of a case of EB virus invading the cerebellum of child,who was admitted to the Children′s Hospital of Soochow University,was analyzed.Meanwhile,the literature related to the imaging of EB virus encephalitis and the etiology of cerebellum damage was reviewed.Results A previously healthy girl aged 1 year and 2 months was diagnosed as EB virus encephalitis by clinical manifestations,cerebrospinal fluid examination,metagenomic next-generation sequencing(mNGS)of cerebrospinal fluid and imaging examination.The result of mNGS displayed that the number of EB virus sequence detected in peripheral blood was 6 and the number of EB virus sequence detected in cerebrospinal fluid was 4.The head magnetic resonance imaging(MRI)showed cerebellum damage as the main lesion.After 2 weeks of treatment,the lesion was absorbed and the prognosis was good.Conclusion The onset of EB virus encephalitis is rapid,and the clinical manifestations have no obvious specificity compared with other viral encephalitis.Most of the lesions involve gray matter,basal ganglia and deep white matter,and a few involve cerebellum.Imaging changes have certain prompting effects on the prognosis.There are many kinds of viral infections invading the cerebellum,and in the early stage of disease,mNGS technology can play a certain role in the etiological diagnosis.
作者
王曼丽
汤继宏
赵东敬
师晓燕
蒋萍
WANG Manli;TANG Jihong;ZHAO Dongjing;SHI Xiaoyan;JIANG Ping(Children′s Hospital of Soochow University,Jiangsu Suzhou 215000,China)
出处
《中国妇幼健康研究》
2021年第10期1537-1540,共4页
Chinese Journal of Woman and Child Health Research
基金
江苏省卫生健康委科研课题面上资助项目(编号:No.H2018010)
江苏省高等学校自然科学研究面上资助项目(编号:20KJB320017)
苏州市科技计划资助项目(编号:szs2020310)。
