acyclovir and Encephalitis--Japanese

Topics: Acyclovir; Antiviral Agents; Cytomegalovirus Infections; Encephalitis, Japanese; Encephalitis, Viral; Herpes Simplex; Humans; Prognosis; Vidarabine

Japanese encephalitis (JE) is a clinical disease caused by inflammation of the central nervous system. The symptoms of this disease range broadly in severity from mild febrile illness to acute meningomyeloencephalitis. JE has been associated with a variety of neurological abnormalities, such as altered sensorium, seizures, focal neurological deficit, and acute flaccid paralysis (AFP). However, to date, AFP has never been reported as an initial manifestation of JE. Here, we present a case of AFP manifesting as the initial symptom of JE in a Chinese patient. A 30-year-old Chinese man was admitted to the West China Hospital of Sichuan University after experiencing AFP in the right upper limb, followed by hyperpyrexia and unconsciousness. Assay of cerebrospinal fluid from a lumbar puncture revealed high levels of proteins and anti- JE virus IgM antibodies. Intravenous acyclovir was administered; however, the weakness persisted and more extensive muscle wasting from the proximal to distal right upper limb occurred over 7 months. This case report highlights that JE needs to be added to the differential diagnosis of AFP in adults, especially in JE endemic seasons and areas.

Topics: Acyclovir; Administration, Intravenous; Adult; Antibodies, Viral; Antiviral Agents; Central Nervous System Viral Diseases; China; Encephalitis Virus, Japanese; Encephalitis, Japanese; Humans; Immunoglobulin M; Male; Myelitis; Neuromuscular Diseases; Treatment Outcome

We report a case of Japanese encephalitis that occurred in a woman who had spent only a few days in an area where she could have been exposed to the virus. The risks and protective efficacy of vaccination against Japanese encephalitis virus for travellers who visit endemic areas for only a short period are discussed.

Topics: Acyclovir; Adult; Antibodies, Viral; Encephalitis, Japanese; Female; Flavivirus; Humans; Injections, Intravenous; Malaysia; Risk-Taking; Thailand; Travel