RESUMO
Tick-borne encephalitis (TBE) is a disease which may present as meningitis, encephalomeningitis and myeloencephalomeningitis. The course of the disease is usually mild although it may result in the patient's death in 1-4% of cases. Patients with myeloencephalomeningitis are the most endangered group, but also encephalomeningitis may have a fatal outcome. There are many risk factors which influence the severity of TBE, including patient's age, immunosuppression and concomitant diseases. We present four cases of patients who died because of TBE. The aim of the paper was to underline that in elderly patients or patients suffering from chronic diseases and additional infections, special attention should be paid to their treatment, including mechanical ventilation and steroid use.
Assuntos
Vírus da Encefalite Transmitidos por Carrapatos/isolamento & purificação , Encefalite Transmitida por Carrapatos/diagnóstico , Meningite Viral/diagnóstico , Meningoencefalite/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Encefalite Transmitida por Carrapatos/líquido cefalorraquidiano , Encefalite Transmitida por Carrapatos/tratamento farmacológico , Encefalite Transmitida por Carrapatos/patologia , Evolução Fatal , Feminino , Humanos , Masculino , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/tratamento farmacológico , Meningite Viral/patologia , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/tratamento farmacológico , Meningoencefalite/patologia , Pessoa de Meia-Idade , PolôniaRESUMO
Herpetic encephalitis (HSE) is one of the most severe infections of Central Nervous System (CNS). If not treated, it results in patient's death in 70% cases, although in properly treated cases the mortality rate is 30%. The most endangered group are patients with immunosuppression, including pregnant women and women in the peripartum period. We present a case of a young woman in puerperium period, who developed herpetic encephalitis. Despite proper treatment patient required long term hospitalization in ICU, where she was placed in pharmacological coma. Despite severe course of the disease no neurological sequelae were observed. The aim of this paper was to emphasize the necessity of immediate antiviral therapy with Acyclovir in all cases suspected of HSE. Additionaly HSE may progress rapidly and ICU treatment should be considered.