PMC9530976_01
On 15 April, NGS results of cerebrospinal fluid showed that the pathogen of encephalitis in this patient was pseudorabies virus, and the genome coverage rate was 1.86%.
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F1
Brain magnetic resonance imaging (MRI): multiple spots and bands of abnormal signals were found in the left insula and temporal cortex, T2WI and T2 flair showed hyperintensity, T1 flair showed isointensity and hypointensity, and GD-DTPA enhanced scanning showed no obvious abnormal enhancement, as shown in Figure 1.
Brain magnetic resonance and eye examination results. (A,B) On 15 April, brain magnetic resonance showed multiple spots and bands of abnormal signals in the left insular and temporal cortex, high signal in T2WI and T2flair, and equal and low signal in T1flair. (C,D) On 24 April, MRI showed abnormal signal and meningeal changes in the left frontal temporal insula. (E,F) On 04 June, magnetic resonance imaging showed that the range of inflammatory lesions was slightly smaller than before. (G) The pupil of the patient was significantly enlarged, with a diameter of 5 x 5 mm. (H) Fundus lesions: vitreous cavity is turbid, the optic disc boundary is indistinctly seen, and white line changes can be seen in the peripheral momentum. (I): No abnormality was found in eyeball magnetic resonance.
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F2
The second generation sequencing results of cerebrospinal fluid showed that it was infected with pseudorabies virus with a coverage rate of 1.86%, see Figure 2 for details. There was no congestion in the conjunctiva of both eyes, the cornea was transparent, the anterior chamber was deep, the crystal was transparent, the pupils of both eyes were fixed and dilated, 5 x 5 mm, the pupil margin was adhered to the front surface of the lens, pigmented keratic precipitates (KP) could be seen in the pupil area, fundus: vitreous cavity was turbid, the boundary of the optic disc could be seen faintly, and white linear changes could be seen in the peripheral omentum; The right eye macular OCT showed that the morphology of the right eye fovea was recognizable, the inner surface of the macular retina was still smooth, and the local ellipsoid structure was slightly disordered, see Figure 2 for details. The OCT of the left eye macular did not cooperate.