Bir Varicella ensefaliti olgusunda klinik ve radyolojik bulgular
Küçük Resim Yok
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türk Mikrobiyoloji Cemiyeti
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Varicella-Zoster virus infeksiyonları (suçiçeği) erişkinlerde ve immünitesi sağlam olgularda nadir olup komplikasyonları fatal seyredebilmektedir. Daha öncesinde sağlıklı olan 29 yaşındaki erkek hasta, suçiçeği döküntülerinden beş gün sonra baş dönmesi, bulantı ve dengesizlik yakınması ile acil servise getirilmiştir. Hastanın yapılan ilk beyin-omurilik sıvısı (BOS) ve kan incelemelerinde Varicella-Zoster antikorları negatif bulunmasına karşılık onuncu günde yapılan incelemelerde hem kan hem BOS'ta antikorlar pozitif olarak saptanmıştır. Kontrastlı kraniyal manyetik rezonans görüntüleme (MRG)' sinde patoloji saptanmayan hastanın Technetium-99m-hegzametilpropilenaminoksim (Tc-99m-HMPAO) ile işaretli beyin tek foton emisyon bilgisayarlı tomografi (single photon emission computed tomography: SPECT) incelemesinde; sağ serebral ve iki yanlı serebellar hipoperfüzyon saptanmıştır. On günlük antiviral tedavi sonrası kısmi klinik düzelme sağlanan hastanın, üç ay sonraki kontrolünde nörolojik muayenesindeki patolojilerde tama yakın düzelme saptanmıştır. Bu dönemde tekrarlanan kraniyal MRG incelemesi normal olarak bulunmasına karşın Tc-99m HMPOA Beyin SPECT incelemesinde daha önceden saptanan patolojinin devam ettiği görülmüştür. Bu yazıda, olgunun klinik ve radyolojik bulguları literatür bilgileri ışığında tartışılmıştır.
The Varicella-Zoster virus infection (chicken pox) is rarely seen in adults and subjects with normal immunity, but its complications might be fatal. A 29-year-old previously healthy male patient applied to the emergency ward five days after the occurrence of chicken pox rashes with complaints of vertigo, nausea, and imbalance. Although Varicella-Zoster antibodies were found to be negative in the initial cerebrospinal fluid (CSF) and blood examinations of the patient, these antibodies were detected both in the CSF and blood of the patient on the tenth day. Right cerebellar and bilateral cerebellar hypoperfusion were determined with brain single photon emission tomography (SPECT) labelled with Tc-99m hexamethyl propylene amine oxime (HMPAO) whereas no pathologies were detected in the contrasted cranial magnetic resonance imaging (MRI). Partial clinical improvement was achieved after a 10-day antiviral therapy and an almost complete improvement was observed in the neurological examination of the patient at the third month follow up. Although the repeated cranial MRI examination performed in this period was found to be normal, in the Tc-99 HMPOA brain SPECT examination it was observed that the previously determined pathology continued to exist. In this article, the clinical and radiological findings of the case are discussed in the light of the literature.
The Varicella-Zoster virus infection (chicken pox) is rarely seen in adults and subjects with normal immunity, but its complications might be fatal. A 29-year-old previously healthy male patient applied to the emergency ward five days after the occurrence of chicken pox rashes with complaints of vertigo, nausea, and imbalance. Although Varicella-Zoster antibodies were found to be negative in the initial cerebrospinal fluid (CSF) and blood examinations of the patient, these antibodies were detected both in the CSF and blood of the patient on the tenth day. Right cerebellar and bilateral cerebellar hypoperfusion were determined with brain single photon emission tomography (SPECT) labelled with Tc-99m hexamethyl propylene amine oxime (HMPAO) whereas no pathologies were detected in the contrasted cranial magnetic resonance imaging (MRI). Partial clinical improvement was achieved after a 10-day antiviral therapy and an almost complete improvement was observed in the neurological examination of the patient at the third month follow up. Although the repeated cranial MRI examination performed in this period was found to be normal, in the Tc-99 HMPOA brain SPECT examination it was observed that the previously determined pathology continued to exist. In this article, the clinical and radiological findings of the case are discussed in the light of the literature.
Açıklama
Anahtar Kelimeler
Varicella-Zoster Virus, ensefalit, MRG, SPECT
Kaynak
İnfeksiyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
2
Künye
Şahin, Ş., Sivrel Arısoy, A., Eren Topkaya, A. ve Karşıdağ, S. (2006). Bir Varicella ensefaliti olgusunda klinik ve radyolojik bulgular / Clinical and radiological findings in a case of Varicella encephalitis. İnfeksiyon Dergisi, Türk Mikrobiyoloji Cemiyeti. 20(2), s.131-135.
