Acute hepatitis E virus infection presenting as meningo-encephalitis.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2024-08-14 DOI:10.1007/s15010-024-02361-3

Moritz Hafkesbrink, M Schemmerer, J J Wenzel, S Isenmann

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Abstract

Background: Acute hepatitis E infection (HEV), with its high incidence in Europe, should be considered as a differential diagnosis of acute viral hepatitis and can in some cases manifest with pronounced neurological symptoms.

Clinical case: We report on a 33-year-old female patient with severe arthralgia, myalgia, headache and psychomotor deterioration. Laboratory analyses showed elevated transaminases without signs of cholestasis. Acute hepatitis E virus infection was detected in serum. She reported fatigue and dysesthesias not responsive to analgesics. Cerebrospinal fluid (CSF) analysis revealed an inflammatory syndrome. HEV RNA was detected in the CSF. The infection remained mild, but dysesthesias persisted. Eight weeks after the first admission, the symptoms worsened again. Complete and sustained remission was achieved following intravenous corticosteroid treatment.

Conclusion: In patients with acute neurological symptoms and liver enzyme elevation, HEV infection should be considered. Neurologic symptoms such as fatigue, arthralgia, myalgia and dysesthesia along with psychomotor retardation should prompt CSF analysis.

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表现为脑膜脑炎的急性戊型肝炎病毒感染。

背景：急性戊型肝炎感染（HEV）在欧洲的发病率很高，应将其作为急性病毒性肝炎的鉴别诊断，在某些情况下可表现为明显的神经系统症状：我们报告了一名 33 岁的女性患者，她患有严重的关节痛、肌痛、头痛和精神运动性衰退。实验室分析显示转氨酶升高，但无胆汁淤积症状。血清中检测到急性戊型肝炎病毒感染。她报告了乏力和对镇痛药无反应的疼痛。脑脊液（CSF）分析显示存在炎症综合征。脑脊液中检测到 HEV RNA。感染仍然很轻微，但疼痛持续存在。首次入院八周后，症状再次恶化。经静脉注射皮质类固醇治疗后，症状得到完全和持续缓解：结论：对于出现急性神经系统症状和肝酶升高的患者，应考虑 HEV 感染。疲劳、关节痛、肌痛和感觉异常等神经系统症状以及精神运动性迟滞应及时进行脑脊液分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.