目的分析2013-2021年宝鸡市急性脑炎脑膜炎症候群(Acute Meningeal and Encephalitis Syndrome,AMES)监测病例中乙型脑炎(乙脑)病例的构成和临床特征,为指导乙脑病例的诊断提供依据。方法按照宝鸡市AMES病例定义开展监测,所有病例进行...目的分析2013-2021年宝鸡市急性脑炎脑膜炎症候群(Acute Meningeal and Encephalitis Syndrome,AMES)监测病例中乙型脑炎(乙脑)病例的构成和临床特征,为指导乙脑病例的诊断提供依据。方法按照宝鸡市AMES病例定义开展监测,所有病例进行乙型脑炎病毒IgM抗体检测,对阳性病例按照入院诊断分为乙脑疑似病例组和非乙脑疑似病例组,比较两组病例临床表现与脑脊液生化特征的差异,比较监测实施前后宝鸡地区乙脑病例在陕西省的占比。结果2013-2021年共报告AMES病例2636例,乙脑IgM阳性158例,阳性率为5.99%,其中72例(45.57%)从入院诊断为疑似乙脑病例中检出,86例(54.43%)从AMES其它诊断中检出。临床表现为头痛、恶心、呕吐、抽搐比例在疑似和非疑似乙脑病例中无统计学意义(P>0.05)。发热、意识障碍、颈项强直、脑膜刺激征在疑似乙脑病例组高于非疑似乙脑病例组(P<0.05)。入院诊断为乙脑疑似病例和非乙脑疑似病例的脑脊液外观、蛋白含量、白细胞计数、葡萄糖和氯化物含量无统计学差异(P>0.05)。2005-2012年宝鸡市乙脑病例数占全省的10.65%(134/1258),2013-2021年占16.58%(161/971)。结论急性脑炎脑膜炎症候群监测可提高乙脑检出率,指导临床对乙型脑炎病例的诊断,应继续加强监测。展开更多
Background: A combination of acute urinary retention and aseptic meningitis has not been well known. This combination can be referred to as meningitis-retention syndrome (MRS), when accompanied by no other abnormaliti...Background: A combination of acute urinary retention and aseptic meningitis has not been well known. This combination can be referred to as meningitis-retention syndrome (MRS), when accompanied by no other abnormalities. Objective: To describe the results of a uro-neurological assessment in our patients with MRS. Methods: In three patients (two men, one woman; age, 34- 68 years), we performed urodynamic studies and relevant imaging and neurophysiological tests, in addition to cerebrospinal fluid (CSF) examination. Results: All three patients developed acute urinary retention along with headache, fever and stiff neck. None had obvious neurological abnormalities, other than a slightly brisk reflex in the lower extremities. One had previously experienced generalized erythematous eruptions, but none had pain, hypalgesia or skin eruptions in the sacral dermatomes suggestive of Elsberg syndrome (infectious sacral polyradiculitis; mostly genital herpes). Brain/spinal/lumbar plexus MRI scans and nerve conduction studies were normal. CSF examination showed mild mononuclear pleocytosis, increased protein content, and normal to mildly decreased glucose content in all patients; increased myelin basic protein suggestive of central nervous system demyelination in one; and increased viral titers in none. Urodynamic study revealed, during the voiding phase, an underactive detrusor in all patients and an unrelaxing sphincter in one. These clinical manifestations were ameliorated within 3 weeks. Conclusions: We reported three cases of MRS, a peculiar syndrome that could be regarded as a mild variant of acute disseminated encephalomyelitis (ADEM). Urinary retention might reflect acute shock phase of this disorder. Although MRS has a benign and self-remitting course, management of the acute urinary retention is necessary.展开更多
文摘目的分析2013-2021年宝鸡市急性脑炎脑膜炎症候群(Acute Meningeal and Encephalitis Syndrome,AMES)监测病例中乙型脑炎(乙脑)病例的构成和临床特征,为指导乙脑病例的诊断提供依据。方法按照宝鸡市AMES病例定义开展监测,所有病例进行乙型脑炎病毒IgM抗体检测,对阳性病例按照入院诊断分为乙脑疑似病例组和非乙脑疑似病例组,比较两组病例临床表现与脑脊液生化特征的差异,比较监测实施前后宝鸡地区乙脑病例在陕西省的占比。结果2013-2021年共报告AMES病例2636例,乙脑IgM阳性158例,阳性率为5.99%,其中72例(45.57%)从入院诊断为疑似乙脑病例中检出,86例(54.43%)从AMES其它诊断中检出。临床表现为头痛、恶心、呕吐、抽搐比例在疑似和非疑似乙脑病例中无统计学意义(P>0.05)。发热、意识障碍、颈项强直、脑膜刺激征在疑似乙脑病例组高于非疑似乙脑病例组(P<0.05)。入院诊断为乙脑疑似病例和非乙脑疑似病例的脑脊液外观、蛋白含量、白细胞计数、葡萄糖和氯化物含量无统计学差异(P>0.05)。2005-2012年宝鸡市乙脑病例数占全省的10.65%(134/1258),2013-2021年占16.58%(161/971)。结论急性脑炎脑膜炎症候群监测可提高乙脑检出率,指导临床对乙型脑炎病例的诊断,应继续加强监测。
文摘Background: A combination of acute urinary retention and aseptic meningitis has not been well known. This combination can be referred to as meningitis-retention syndrome (MRS), when accompanied by no other abnormalities. Objective: To describe the results of a uro-neurological assessment in our patients with MRS. Methods: In three patients (two men, one woman; age, 34- 68 years), we performed urodynamic studies and relevant imaging and neurophysiological tests, in addition to cerebrospinal fluid (CSF) examination. Results: All three patients developed acute urinary retention along with headache, fever and stiff neck. None had obvious neurological abnormalities, other than a slightly brisk reflex in the lower extremities. One had previously experienced generalized erythematous eruptions, but none had pain, hypalgesia or skin eruptions in the sacral dermatomes suggestive of Elsberg syndrome (infectious sacral polyradiculitis; mostly genital herpes). Brain/spinal/lumbar plexus MRI scans and nerve conduction studies were normal. CSF examination showed mild mononuclear pleocytosis, increased protein content, and normal to mildly decreased glucose content in all patients; increased myelin basic protein suggestive of central nervous system demyelination in one; and increased viral titers in none. Urodynamic study revealed, during the voiding phase, an underactive detrusor in all patients and an unrelaxing sphincter in one. These clinical manifestations were ameliorated within 3 weeks. Conclusions: We reported three cases of MRS, a peculiar syndrome that could be regarded as a mild variant of acute disseminated encephalomyelitis (ADEM). Urinary retention might reflect acute shock phase of this disorder. Although MRS has a benign and self-remitting course, management of the acute urinary retention is necessary.
