BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses...BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.展开更多
目的分析脑膜血管型神经梅毒(meningeal vascular type of syphilis,MVTS)的MRI表现,以提高对该病的诊断能力。方法回顾性收集6例经脑脊液和血清学检查确诊的MVTS的MRI资料,分析其MRI表现。结果 MVTS可以表现FLAIR序列蛛网膜下腔或软脑...目的分析脑膜血管型神经梅毒(meningeal vascular type of syphilis,MVTS)的MRI表现,以提高对该病的诊断能力。方法回顾性收集6例经脑脊液和血清学检查确诊的MVTS的MRI资料,分析其MRI表现。结果 MVTS可以表现FLAIR序列蛛网膜下腔或软脑膜表面多发的高信号小结节影,伴有邻近软脑膜及脑回肿胀、脑沟变窄,脑膜梅毒树胶肿可以伴发有脑内多发结节状梅毒肉芽肿,脑膜梅毒树胶肿花冠样强化,脑内梅毒肉芽肿可环形强化或结节样强化,FLAIR序列复查可显示脑内病灶高信号范围增大,DWI见稍高信号的范围逐渐缩小,FLAIR与DWI可显示病灶由细胞毒性脑水肿向血管源性脑水肿转变。结论 MVTS的MRI表现具有多样性,MRI检查对明确诊断MVTS仍具有重要意义。展开更多
文摘BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
文摘目的分析脑膜血管型神经梅毒(meningeal vascular type of syphilis,MVTS)的MRI表现,以提高对该病的诊断能力。方法回顾性收集6例经脑脊液和血清学检查确诊的MVTS的MRI资料,分析其MRI表现。结果 MVTS可以表现FLAIR序列蛛网膜下腔或软脑膜表面多发的高信号小结节影,伴有邻近软脑膜及脑回肿胀、脑沟变窄,脑膜梅毒树胶肿可以伴发有脑内多发结节状梅毒肉芽肿,脑膜梅毒树胶肿花冠样强化,脑内梅毒肉芽肿可环形强化或结节样强化,FLAIR序列复查可显示脑内病灶高信号范围增大,DWI见稍高信号的范围逐渐缩小,FLAIR与DWI可显示病灶由细胞毒性脑水肿向血管源性脑水肿转变。结论 MVTS的MRI表现具有多样性,MRI检查对明确诊断MVTS仍具有重要意义。
