Đặc điểm trẻ viêm não herpes simplex virus tại Bệnh viện Nhi Đồng 1

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Tác giả: An Nghĩa Nguyễn, Thị Thủy Tiên Nguyễn

Ngôn ngữ: Vie

Ký hiệu phân loại: 618.92 Pediatrics

Thông tin xuất bản: Tạp chí Y học TP. Hồ Chí Minh 2021

Mô tả vật lý: 82-88

Bộ sưu tập: Metadata

ID: 408658

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Khảo sát đặc điểm dịch tễ, lâm sàng, cận lâm sàng, điều trị của trẻ viêm não do HSV (HSE) từ 2 tháng tại khoa Nhiễm bệnh viện Nhi Đồng 1. Đối tượng - Phương pháp: Nghiên cứu mô tả loạt ca 32 trẻ HSE đủ tiêu chuẩn được đưa vào nghiên cứu, tập trung ở 5 - 10 tuổi (50%). Kết quả: từ 01/2017 đến 01/2020 có 32 trẻ HSE đủ tiêu chuẩn được đưa vào nghiên cứu, tập trung ở 5 - 10 tuổi (50%). Tỉ lệ nam: nữ là 1:1. Các triệu chứng thường gặp là sốt (62,5%) và co giật (53,1%). Bệnh diễn tiến với triệu chứng nói nhảm (9,4%), rối loạn vận động (9,4%), nhiễm trùng bệnh viện (21,9%), suy thận (3,1%), tăng men gan (3,1%). CT-scan và MRI sọ não ghi nhận tổn thương ở đồi thị, vùng đính, vùng trán và vùng thái dương lần lượt trong 61,9% và 40,9% trường hợp. EEG ghi nhận sóng chậm ở 45,5% bệnh nhi. 13,6% acyclovir được điều trị trong 72 giờ đầu của bệnh. Không ghi nhận ca tử vong. Các di chứng thường gặp: co giật - co gồng cơ (21,9%), yếu liệt (21,9%), kém tiếp xúc (9,4%). Kết luận: HSV là tác nhân viêm não trẻ em đáng quan tâm tại Việt Nam. Khi hình ảnh học sọ não có tổn thương tại vùng đồi thị, vùng đính, vùng trán hay vùng thái dương, chẩn đoán HSE cần được đưa ra để acyclovir truyền tĩnh mạch được sử dụng sớm trong 72 tiếng đầu tiên của bệnh giúp cải thiện tiên lượng cho bệnh nhi., Tóm tắt tiếng anh, Herpes simplex virus (HSV) is the most common cause of encephalitis worldwide, including Vietnam. Researches in children with herpes simplex encephalitis in Vietnam are limited. Objective: Describe epidemiology, clinical characteristics, laboratory findings, treatments and outcomes of children from 2 months old who was diagnosed with herpes simplex encephalitis (HSE) at the Department of Infectious Diseases of Children's Hospital 1. Method: Case series study 32 children who were diagnosed with HSE. HSE occurred in every period of childhood but the highest incidence was between 5 and 10 years old (50%). Results: From 01/2017 to 01/2020, there were 32 children who were diagnosed with HSE. HSE occurred in every period of childhood but the highest incidence was between 5 and 10 years old (50%), the male:female ratio was 1:1. The most common chief complaints were fever (62.5%) and seizure (53.1%). The progression of disease usually got worse during staying in hospital with maundering symptom (9.4%), mobility disorder (9.4%), hospital-acquired infection (21.9%), renal failure (3.1%), elevation of hepatic enzymes (3.1%). Cranial CT-scan and MRI findings in thalamic, parietal, frontal and temporal regions were seen in 61,9% and 40,9% of all cases, respectively. EEG wave was seen in 45.5% of patients. 13.6% of cases received intravenous acyclovir administration in the first 72 hours of disease. There was no death in this study group. Common neurologic sequela included seizures (21.9%), paralysis (21.9%), poor contact (9.4%). Conclusions: HSV is a considerable agent causing children encephalitis in Vietnam. When having abnormal findings in cranial imaging in thalamic, parietal, frontal and temporal regions, diagnosis of HSE needs carrying out so that intravenous acyclovir is used in the first 72 hours of disease to improve outcome of patient.

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