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首页> 外文期刊>Emerging Infectious Diseases >Importation of West Nile Virus Infection from Nicaragua to Spain
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Importation of West Nile Virus Infection from Nicaragua to Spain

机译：从尼加拉瓜向西班牙进口西尼罗河病毒感染

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To the Editor: We report the case of a 51-year-old Spanish missionary who had lived Nicaragua (Managua) from 2004 to 2006. He had no other notable travel history during that pe-riod. In June 2006, he noticed malaise and nausea, followed by abrupt onset of fever (39°C), headache, cervical pain, and right hemiparesis. He was admitted to a local hospital in Nicara-gua, at which time routine results of hematologic and biochemistry tests were within normal limits, except for mild neutrophilia. After cerebral mag-netic resonance imaging (MRI), a di-agnosis of ischemic cerebrovascular accident was made. He was treated with aspirin and ceftriaxone for an oropharyngeal infection.Because neurologic symptoms persisted, 13 days later he was trans-ferred to a hospital in Madrid, Spain. At that time, physical examination showed neck stiffness, a diminished level of consciousness, right . accid hemiparesis, and facial weakness. Pe-ripheral blood examination showed only mild neutrophilia. Cerebrospi-nal . uid (CSF) analysis showed a 65 mg/dL glucose level (blood glucose 140), proteins 136 g/dL, and 18 cells/mm3(mainly lymphocytes). Serologic test results for HIV, hepatitis B virus, hepatitis C virus, syphilis, Toxoplasma spp., and Brucella spp., and CSF cul-tures for mycobacterial, bacterial, and fungal infections were all negative. Re-sults of a computed tomographic scan of the brain were within normal limits. MRI showed nonspecifi c abnormal intensity of white matter signal. Elec-trophysiologic studies showed severe axonal motor neuropathy and mod-erate sensitive axonal neuropathy in the right upper limb. Gammaglobulin was administered intravenously for 5 days; the patient improved slightly. Atdischarge, the diagnosis was of "Guil-lain-Barré–like syndrome." He was admitted to our Tropical Medicine Unit in Madrid, 160 days after onset of intial symptoms. West Nile virus (WNV) infection was suspected, and diagnostic tests were performed on all available samples. The fi rst serum (S1) and CSF samples obtained 13 days after onset of symptoms were sent to us for testing. A second serum sample (S2) was obtained at 160 days
机译：致编辑：我们报告了一名51岁的西班牙传教士的案例，他从2004年至2006年居住在尼加拉瓜（马那瓜）。在此期间，他没有其他值得注意的旅行经历。在2006年6月，他注意到全身不适和恶心，随后突然发烧（39°C），头痛，颈椎疼痛和右偏瘫。他住进了尼加拉瓜的一家当地医院，当时血液和生化检查的常规结果在正常范围内，除了轻度中性粒细胞增多症。经过脑磁共振成像（MRI），进行了缺血性脑血管意外的诊断。他因口咽感染接受了阿司匹林和头孢曲松的治疗。由于神经系统症状持续存在，因此13天后，他被转送到西班牙马德里的一家医院。当时，体格检查显示颈部僵硬，意识水平下降，对。偏头痛，面部无力。外周血检查仅显示轻度中性粒细胞增多。脑脊髓。 uid（CSF）分析显示葡萄糖水平为65 mg / dL（血糖为140），蛋白质为136 g / dL，细胞为18个细胞/ mm3（主要是淋巴细胞）。 HIV，乙型肝炎病毒，丙型肝炎病毒，梅毒，弓形虫和布鲁氏菌的血清学检测结果以及分枝杆菌，细菌和真菌感染的脑脊液培养均为阴性。对大脑进行计算机断层扫描的结果在正常范围内。 MRI显示非特异性白质信号强度异常。电生理研究显示右上肢严重的轴突运动神经病和中度敏感的轴突神经病。丙种球蛋白静脉注射5天;病人略有好转。出院时诊断为“类似吉兰·巴雷综合征”。最初症状发作后160天，他被送往马德里的热带医学科。怀疑有西尼罗河病毒（WNV）感染，并对所有可用样品进行了诊断测试。症状发作后第13天获得的第一份血清（S1）和CSF样品发送给我们进行测试。在160天后获得第二份血清样品（S2）

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