tailieunhanh - Báo cáo y học: "Subacute herpes simplex virus type 1 encephalitis as an initial presentation of chronic lymphocytic leukemia and multiple sclerosis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Treatment of stasis dermatitis using aminaphtone: Subacute herpes simplex virus type 1 encephalitis as an initial presentation of chronic lymphocytic leukemia and multiple sclerosis: a case report. | Singhal and Corman Journal of Medical Case Reports 2011 5 59 http content 5 1 59 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Subacute herpes simplex virus type 1 encephalitis as an initial presentation of chronic lymphocytic leukemia and multiple sclerosis a case report Rashi L Singhal Lourdes C Corman Abstract Introduction Herpes simplex virus type 1 encephalitis presents acutely in patients who are immunocompetent. We report on what we believe to be the first published case of a subacute course of herpes simplex virus type 1 encephalitis in a patient with asymptomatic chronic lymphocytic leukemia who subsequently developed multiple sclerosis. Case presentation A 49-year-old Caucasian woman with a history of fever blisters presented to our emergency department with a history of left temporal headache for four weeks and numbness of the left face and leg for two weeks. A complete blood count revealed white blood cells at 11 820 cells mL with absolute lymphocytes at 7304 cells mL. The cerebrospinal fluid contained 6 white blood cells pL 63 red blood cells pL 54 mg glucose dL and 49 mg total protein dL. Magnetic resonance imaging of the brain revealed meningoencephalitis and bilateral ventriculitis. Cerebrospinal fluid polymerase chain reaction for herpes simplex virus type 1 was positive and our patient s symptoms resolved after ten days of treatment with parenteral aciclovir. Incidental findings on peripheral blood smear and flow cytometry testing confirmed chronic lymphocytic leukemia. Then one month later she developed bilateral numbness of the hands and feet a repeat cerebrospinal fluid polymerase chain reaction for herpes simplex virus type 1 at this time was negative. A repeat magnetic resonance imaging scan showed an expansion of the peri-ventricular lesions and the cerebrospinal fluid contained elevated oligoclonal bands and myelin basic protein. A brain biopsy revealed gliosis consistent with multiple sclerosis and our