小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 发热 (≥37.5 ℃)
- 流感样症状
- 感觉异常
- 感觉过敏
- 重度持续性头痛
- 头晕
- 眼痛
- 步态障碍
- 共济失调
- 复视
- 激越
- 假性脑膜炎
- 肌无力（麻痹）
- 顽固性呃逆
- 呼吸困难
- 上行性或急性弛缓性麻痹
- 水疱性病变
其他诊断因素
- 恶心/呕吐
- 结膜炎
- 皮疹
- 淋巴结炎
- 淋巴管炎
- 腹痛
危险因素
- 职业暴露
- 前往散养猕猴的国家/地区旅游
- 将猕猴作为宠物饲养
- 暴露于与猕猴一起饲养的非猕猴物种
诊断性检查
首要检查
- 血清学
- 聚合酶链反应 (PCR)
需考虑的检查
- 病毒培养
- 脑部 MRI
- 头颅 CT
- 脑脊液检测
- 脑电图 (EEG)
- 脑干听觉诱发电位
- 躯体感觉诱发电位
- 动物样本的实验室检测
治疗流程
潜在暴露
确诊感染和/或有症状
撰稿人
作者
Richard Whitley, MD
Professor of Pediatrics
Professor of Microbiology, Medicine, and Neurosurgery
University of Alabama
Birmingham
AL
利益声明
RW is a retired Board Member for Gilead Sciences, Inc., and a current member of Scientific Advisory Boards or Data Management Committees for Clear Creek Biosciences, Merck, Virios Therapeutics, Visby Medical, Evrys BioSciences, Enochian Biosciences, and Leyden Laboratories.
鸣谢
Professor Richard Whitley would like to gratefully acknowledge Dr D. Scott Schmid, Dr Jeffrey I. Cohen, and Dr Louisa E. Chapman, previous contributors to this topic, and Dr Julia K. Hilliard for her contributions to this topic. Unfortunately, we have been made aware that Dr Louisa E. Chapman is now deceased.
利益声明
JKH, JIC, and LEC are the authors of several references cited in this topic. DSS declared that he had no competing interests. The views included in this topic are those of the authors (DSS and JIC) and do not necessarily represent the views of the Centers for Disease Control and Prevention or the National Institutes of Health.
同行评议者
Anna Maria Geretti, MD, PhD, FRCPath
Professor of Virology and Infectious Diseases
University of Liverpool
Liverpool
UK
利益声明
AMG declares that she has no competing interests.
Deanna Saylor, MD, MHS
Assistant Professor of Neurology
Johns Hopkins University School of Medicine
Baltimore
MD
利益声明
DS has received research funding from the National Institutes of Health, the World Federation of Neurology, and the Johns Hopkins Center for AIDS Research.
鉴别诊断
- 单纯疱疹病毒性脑炎
- 带状疱疹性脑炎
- 西尼罗河病毒
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