SPECIFIC IDENTIFICATION OF HERPES SIMPLEX VIRUS IN HUMAN ESOPHAGUS WITH RAPID IN SITU HYBRIDIZATION IN 5 CASES

HUMAN herpes simplex virus esophagitis （HSVE） was first reported in 1940 by Johnson. ^1HSVE usually occurs in immunocompromised patients,such as those with acquired immunodeficiency syndrome （AIDS）, 2-4 malignancies, cutaneous burns, connective tissue diseases, inflammatory bowel disease, those taking immuno-suppressive therapy, and those undergoing organ transplantation,5 etc. In the immunocompetent individuals, HSVE is rare, having been reported in 39 cases and mainly affecting young males^6,7 The aim of this study was to delineate the clinical experience in the diagnosis of HSVE using rapid in situ hybridization and assess the various detection methods.     

Relapse of herpes simplex encephalitis after conventional acyclovir therapy

Acyclovir sodium is the drug of choice for the treatment of herpes simplex encephalitis. We treated an immunocompetent patient with a ten-day course of intravenous acyclovir sodium at the recommended dosage of 10 mg/kg every eight hours for clinically apparent herpes simplex encephalitis. After marked improvement, his condition deteriorated four days after completing acyclovir therapy. A subsequent brain biopsy specimen disclosed acyclovir-sensitive herpes simplex virus type 1. A longer duration of acyclovir therapy (14 to 21 days) should be considered for treating herpes simplex encephalitis.     

单纯疱疹病毒感染后自身免疫性脑炎的研究进展

单纯疱疹病毒脑炎所引发的自身免疫性脑炎日益受到关注,其发病机制可能与单纯疱疹病毒感染神经元后神经元裂解释放抗原引起免疫反应有关。这种继发性的自身免疫性脑炎临床表现多样,早期容易与复发性单纯疱疹病毒性脑炎相混淆,延误治疗导致严重的神经功能缺损及预后不良。脑脊液和血清中检出自身免疫性脑炎相关抗体则有助于诊断,免疫治疗有效。本文结合相关文献综述了单纯疱疹病毒感染后的自身免疫性脑炎的发展历史、发病机制、临床表现、辅助检查和诊疗流程,为临床医生提供借鉴。     

Oesophageal ulcers secondary to doxycycline and herpes simplex infection in an immunocompetent patient

Oesophageal ulcerations are generally rare occurrences that are most commonly associated with gastro-oesophageal reflux disorder. Other causes include medications and infections in immunocompromised patients. Among the medications used in daily practice, doxycycline is most commonly implicated. Multiple aetiologies are generally uncommon. We report a case of mid-oesophageal ulcerations secondary to doxycycline and herpes simplex virus infection in an immunocompetent patient.     

PCR-RFLP法对单纯疱疹病毒感染诊断和分型的研究

目的 建立单纯疱疹病毒的聚合酶链反应-限制性片段长度多态性（PCR-RFLP）检测法,为生殖器疱疹的诊断及分型提供可靠而特异的方法。方法 以特异性引物法为对照,用一对单纯疱疹病毒外层通用引物扩增出长度为438bp的片断,并进行酶切以分型。结果 PCR-RFLP法可特异性检测出单纯疱疹病毒并进行分型,同特异性引物法比较。两种方法无显著性差异。结论 PCR-RFLP法是一种准确、特异的对单纯疱疹病毒感染进行诊断和分型的方法。     

Diseases that mimic herpes simplex encephalitis. Diagnosis, presentation, and outcome. NIAD Collaborative Antiviral Study Group

A total of 432 patients underwent brain biopsy for presumptive herpes simplex encephalitis. Three patient groups were identified. The first group, 195 patients (45%), had herpes simplex encephalitis confirmed by the isolation of herpes simplex virus from brain tissue at biopsy (193 patients) or autopsy (2 patients). The second group, 95 patients (22%), had diseases that were identified but that were not caused by herpes simplex virus. Three subgroups were recognized: (1) 38 patients (9%) with treatable disease, (2) 40 patients (9%) with nontreatable but diagnosed viral infection, and (3) 17 patients (4%) with identified diseases neither of viral etiology nor treatable. The third group, 142 patients (33%), remained without a diagnosis. Clinical presentation of patients in the second group was similar to that of those with herpes simplex encephalitis and those without a diagnosis. Patients in the subgroup with nontreatable but diagnosed viral infections had the greatest likelihood of returning to normal.     

ELISA法检测单纯疱疹病毒Ⅱ型特异性抗体的临床应用研究

目的 探讨单纯疱疹病毒Ⅱ型（ＨＳＶ－２）感染的早期特异检测手段。方法 对５２例性病门诊的生殖器疱疹患者改良的ＥＬＩＳＡ方法进行了ＨＳＶ－ｇＤ２ＩｇＧ检测并同细胞分离方法进行对比观察。结果 病毒分离的阳性率为６９．２％,ＥＬＩＳＡ法检测抗体的阳性率６５％,两种方法检测结果差异无显著性。结论：ＥＬＩＳＡ法检测血清疱疹病毒ＩｇＧ抗体具有简便,快速,特异的优点,适合于临床大规模检测之有     

Herpes simplex encephalitis in infants

Two cases are reported of severe encephalitis in infants that were caused by a primary infection with herpes simplex virus type 1. Both patients presented with focal seizures; the clinical diagnosis was confirmed by the rapid appearance of IgM antibody to herpes simplex virus type 1 in cerebrospinal fluid and serum. In spite of the early use of acyclovir, which was administered by the intravenous route, the clinical response was poor and both infants were left with severe neurological impairment.     

免疫组化法对单纯疱疹病毒脑炎早期诊断的意义

目的：探讨免疫组化法对单纯疱疹病毒脑炎（ＨＳＥ）早期诊断的意义。方法：用免疫组化法检测９例ＨＳＥ脑组织石蜡保存标本的单纯疱疹病毒抗原（ＨＳＶ－Ａｇ）。结果：４例存在ＨＳＶ－Ａｇ，ＨＳＶ－Ａｇ分布于大脑皮质的神经元、胶质细胞、单核细胞。结论：免疫组化法检测脑组织中ＨＳＶ－Ａｇ是ＨＳＥ早期诊断的敏感方法之一。     

病毒感染性眼病病原学诊断的研究进展

多种病毒可导致眼部疾病，包括腺病毒、人类疱疹病毒、人类T淋巴细胞白血病病毒1型（HTLV-1）及新发现的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）等。这类疾病的鉴别诊断较困难，容易被误诊和漏诊，导致严重的组织损伤和视觉损伤。腺病毒、单纯疱疹病毒1型和水痘-带状疱疹病毒相关眼病的诊断中，病原学诊断可作为一种强有力的辅助诊断工具；而在单纯疱疹病毒2型、巨细胞病毒、EB病毒、人类疱疹病毒6型和7型、人类疱疹病毒8型、HTLV-1和SARS-CoV-2相关眼病的诊断中，病原学诊断则发挥着主导作用。病毒培养、免疫组织化学或免疫荧光法及以PCR为代表的病毒基因诊断法是三种主要的病原检测手段，其中PCR技术检测快速、操作便捷、敏感度和特异度高，成为眼科病毒学诊断中最重要的工具。     

Herpes simplex virus in idiopathic facial paralysis (Bell palsy).

Sera from all 41 adult patients with idiopathic facil paralysis (Bell palsy) and 35 (85%) of 41 matched controls who had never had Bell palsy contained antibodies to herpes simplex virus (P smaller than.05). The frequency of antibodies to herpes zoster virus did not differ in patients and controls. A rise in antibody titer, indicating primary herpes simplex virus infection, was not found in these patients. That Bell palsy may be caused by reactivation of herpes simplex virus is suggested by (1) clinical, neurologic, laboratory, and immunologic similarities between idiopathic facial paralysis and known manifestations of reactivated herpes simplex virus infection, and (2) the known neurotropism of herpes simplex virus, including its presence in latent form in the trigeminal ganglia, and parallels with known facial paralysis due to varicella zoster virus, a closely related agent. The presence of antibodies to herpes simplex virus is the only common factor among the patients tested in this study.     

Herpes simplex encephalitis: treatment with surgical decompression and cytosine arabinoside.

Herpes simplex encephalitis in a 21-year-old man presented as a flu-like illness, followed by inappropriate behaviour, drowsiness and focal neurologic signs. Investigations indicated a lesion in the right temporal lobe. The diagnosis was confirmed by isolation of the virus from a cerebral biopsy. Pronounced clinical improvement was noted when cytosine arabinoside therapy was started in the postoperative period. This report supports the observation by some authors that cytosine arabinoside may be of value in the treatment of herpes simplex encephalitis.     

单克隆抗体连接APAAP桥联酶标技术用于单疱性角膜炎的病毒抗原检测

将单克隆抗体连接APAAP桥联酶标技术用于免实验性Ⅰ型单纯疱疹病每性角膜炎病毒抗原的检测,确定了该方法的敏感性和诊断效果,通过与组织培养病毒分离法和间接免疫荧光法比较,提示APAAP复合物免疫酶标技术是用于诊断实验性单疱性角膜炎的一种简便、快速、特异和敏感的方法。     

Herpes Simplex Encephalitis: Two Fatal Cases

The clinical and pathological features of the first two reported cases of herpes simplex encephalitis occurring in Saskatchewan are presented. The clinical history of an acute onset, an early organic mental syndrome followed by coma, neurologic disturbances, rapid progression and death suggests the diagnosis. The acute, diffuse, inflammatory process with predominant involvement of the temporal lobes of the cerebral hemispheres and the presence of intranuclear inclusions in nerve and glial cells are illustrated. The viral particles were found in electron micrographs from the brain tissue of both patients. The definitive diagnosis was established by the isolation, from postmortem brain tissue, of the herpes simplex virus, which was grown in tissue culture and shown to be pathogenic in suckling mice.     

畸胎组织中分获一株病毒的鉴定

从一例畸胎组织标本中分离培养出一株。根据病毒在鸡胚绒毛尿囊膜上增殖、细胞感染范围试验、中和试验以及母血和畸胎血特异性ＩｇＧ和ＩｇＭ检查试验结果，确认该病毒为Ⅱ型单纯疱疹病毒。     

Frequency of asymptomatic shedding of herpes simplex virus in women with genital herpes

Twenty-seven women with recurrent genital herpes simplex virus infection underwent daily home culturing to detect asymptomatic genital herpes simplex virus shedding. Asymptomatic herpes simplex virus shedding was documented on 1% of the days on which cultures were obtained. Asymptomatic shedding from the vulva was as frequent as asymptomatic cervicovaginal shedding, and 45% of asymptomatic episodes were identified only by positive results from vulvar cultures. All women who obtained samples on more than 100 days and 80% of women who obtained samples on more than 50 days had documented asymptomatic viral shedding, compared with only 6% of those who obtained samples for fewer than 25 days. Asymptomatic shedding was not related to contraceptive use or menstrual cycle. These data suggest that all women with recurrent genital herpes simplex virus infection should be instructed about the possible risk, albeit infrequent, of asymptomatically shedding virus from the genital tract.     

366例患者单纯疱疹Ⅱ型病毒感染的分析

目的:了解单纯疱疹Ⅱ型病毒(HSV2)感染与性传播疾病(性病)、流产、死(畸)胎和不孕不育等疾病的关系。方法:应用酶联免疫吸附试验(ELISA)检测HSV2-IgMI、gG抗体,对366例患者和80例健康对照者HSV2感染状态进行调查分析。结果:HSV2-IgMI、gG抗体阳性率患者组:13.1%、49.2%(48/366、180/366);对照组2.5%、25.0%(2/80、20/80),两组阳性率比较,差异非常显著(χ2=7.431,15.519;P<0.01,P<0.01)。结论:HSV2感染与性病、流产、死(畸)胎和不孕不育等疾病的部分患者的发病有关。     

角膜接触镜联合激素治疗病毒性角膜炎的探讨

目的探讨佩戴软性治疗性角膜接触镜联合激素治疗单纯疱疹病毒性角膜葡萄膜炎（溃疡型）的临床疗效。方法对临床确诊的32例单纯疱疹病毒性角膜葡萄膜炎（溃疡型）,静脉滴注或口服阿昔洛韦,0.15%更昔洛韦眼凝胶滴眼、散瞳,佩戴软性治疗性角膜接触镜保护下使用激素治疗。观察眼部刺激症状、角膜溃疡愈合情况,治愈时间。随访3个月。结果佩戴软性治疗性角膜接触镜后药物治疗3天全部改善临床症状,7天浅层溃疡愈合,14-21天中层溃疡愈合,30-35天深层溃疡愈合,40天角膜溃疡小穿孔2眼愈合。32眼治愈29眼,治愈率91%,好转2眼,平均治愈时间16.3天。随访3个月,4眼复发。结论佩戴软性治疗性角膜接触镜联合激素治疗单纯疱疹病毒性角膜葡萄膜炎（溃疡型）临床疗效好,是一种安全实用的治疗方法。     

Sexually transmitted proctitis

Sexually transmitted infections such as chlamydia, gonorrhoea, herpes simplex virus and syphilis commonly present with rectal symptoms. Recent outbreaks of lymphogranuloma venereum among homosexual men throughout Europe highlight the need to consider sexually transmitted infections in the differential diagnosis of proctitis. This article examines the causative organisms, clinical features, diagnosis and treatment of sexually transmitted proctitis.