Author:
Zhang Yi,Fang Lei,Zhou Yi,Zhang Yongqing,Liang Bing,Yan Chuanzhu,Li Ling
Abstract
Abstract
Background
Pseudorabies virus (PRV) was thought to only infect animals. Recent studies have shown that it can also infect human.
Case presentation
We report a case of pseudorabies virus encephalitis and endophthalmitis, diagnosed 89 days after onset, confirmed with intraocular fluid metagenomic next generation sequencing (mNGS) after the result of two cerebrospinal fluid (CSF) mNGS tests were negative. Although treatment with intravenous acyclovir, foscarnet sodium, and methylprednisolone improved the symptoms of encephalitis, significant diagnostic delay resulted in permanent visual loss.
Conclusions
This case suggests that pseudorabies virus (PRV) DNA in the intraocular fluid may have a higher positivity than that in the CSF. PRV may persist in the intraocular fluid for an extended period and may thus require extended antiviral therapy. Patients with severe encephalitis and PRV should be examined with the focus on pupil reactivity and light reflex. A fundus examination should be performed in patients with a central nervous system infection, specifically, those in a comatose state, to help reduce eye disability.
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),General Medicine
Reference29 articles.
1. Iglesias JG, Harkness JW. Studies of transplacental and perinatal infection with two clones of a single Aujeszky’s disease (pseudorabies) virus isolate. Vet Microbiol. 1988;16(3):243–54.
2. Paul PS, Halbur P, Janke B, Joo H, Nawagitgul P, Singh J, et al. Exogenous porcine viruses. Curr Top Microbiol Immunol. 2003;278:125–83.
3. Pomeranz LE, Reynolds AE, Hengartner CJ. Molecular biology of pseudorabies virus: impact on neurovirology and veterinary medicine. Microbiol Mol Biol Rev. 2005;69(3):462–500.
4. Laval K, Vernejoul JB, Van Cleemput J, Koyuncu OO, Enquist LW. Virulent pseudorabies virus infection induces a specific and lethal systemic inflammatory response in mice. J Virol. 2018;92(24):e01614-18.
5. Avak S, Bienzle U, Feldmeier H, Hampl H. Habermehl K-OJTL. Pseudorabies in man. 1987;329(8531):501–2.