{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T14:52:48Z","timestamp":1655823168087},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Einleitung\u2002Das West-Nil-Virus (WNV) ist ein weit verbreitetes Flavivirus, das haupts\u00e4chlich zwischen V\u00f6geln von verschiedenen M\u00fcckenarten (z.\u200aB. Culex, Aedes) \u00fcbertragen wird, aber auch auf S\u00e4ugetiere einschlie\u00dflich Menschen \u00fcbertragen werden kann. Das Krankheitsspektrum reicht von asymptomatischen Infektionen bis hin zu infekti\u00f6ser Enzephalitis. Risikofaktoren f\u00fcr schwere Erkrankungen sind Alter, Herz-Kreislauf-Erkrankungen und ein immungeschw\u00e4chter Zustand.<\/jats:p><jats:p>\n          Anamnese und klinischer Befund\u2002Hier berichten wir \u00fcber einen 60-j\u00e4hrigen m\u00e4nnlichen Patienten, der 2 Jahre nach seiner Nierentransplantation aufgrund einer hypertensiven Nephropathie mit schwerem Fieber an das Universit\u00e4tsklinikum Halle (Saale) \u00fcberwiesen wurde.<\/jats:p><jats:p>\n          Untersuchungen und Diagnose\u2002Es konnte zun\u00e4chst kein Infektionsfokus gefunden werden. Am 6. Tag im Verlauf seiner Krankheit entwickelte der Patient neurologische Symptome, sodass der Verdacht auf eine virale Enzephalitis gestellt wurde.<\/jats:p><jats:p>\n          Therapie und Verlauf\u2002Die im Raum stehende virale Enzephalitis wurde mit Aciclovir parenteral anbehandelt. Nach initialer Reduktion der Immunsuppression wurde eine koinzidente Funktionsverschlechterung des Nierentransplantats mit Methylprednisolon behandelt. Eine WNV-Infektion wurde aufgrund k\u00fcrzlich aufgetretener F\u00e4lle bei Menschen in der n\u00e4heren Umgebung der Stadt Leipzig vermutet. Es konnte WNV der Linie 2 im Urin des Patienten durch RT-PCR und im Verlauf eine Serokonversion von anti-WNV-IgM zu anti-WNV-IgG nachgewiesen werden. Die Behandlung mit Aciclovir wurde u.\u200aa. daraufhin abgebrochen. Der Patient erholte sich vollst\u00e4ndig und die transplantierte Niere erlangte wieder eine angemessene Funktion. Die Biopsie des Transplantats zeigte keine relevante Absto\u00dfung.<\/jats:p><jats:p>\n          Folgerung\u2002Dieser Fall unterstreicht die Notwendigkeit, seltenere Krankheitsursachen wie die WNV-Infektion insbesondere in Risikogruppen zu ber\u00fccksichtigen. WNV kann mittels PCR im Blut und Liquor fr\u00fch im Verlauf der Infektion nachgewiesen werden, wird aber auch \u00fcber einen l\u00e4ngeren Zeitraum im Urin ausgeschieden. Eine Serokonversion zu anti-WNV-IgG und -IgM kann gezeigt werden, aber die serologische Kreuzreaktivit\u00e4t in der Flavivirus-Familie muss ber\u00fccksichtigt werden.<\/jats:p>","DOI":"10.1055\/a-1218-9096","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T22:45:00Z","timestamp":1617057900000},"page":"482-486","source":"Crossref","is-referenced-by-count":1,"title":["In Deutschland erworbene West-Nil-Virusinfektion bei einem nierentransplantierten Patienten"],"prefix":"10.1055","volume":"146","author":[{"given":"Matthias","family":"Karrasch","sequence":"additional","affiliation":[{"name":"Department f\u00fcr Labormedizin, Abteilung III, Universit\u00e4tsklinikum Halle (Saale)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Pein","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Innere Medizin II, Halle\u00a0(Saale)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annekathrin","family":"Fritz","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Innere Medizin II, Halle\u00a0(Saale)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danica","family":"Lange","sequence":"additional","affiliation":[{"name":"Klinische Infektiologie, Universit\u00e4tsklinikum Halle (Saale)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Moritz","sequence":"additional","affiliation":[{"name":"Klinische Infektiologie, Universit\u00e4tsklinikum Halle (Saale)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin","family":"Amann","sequence":"additional","affiliation":[{"name":"Nephropathologische Abteilung im Pathologischen Institut, Universit\u00e4tsklinikum Erlangen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Schmidt-Chanasit","sequence":"additional","affiliation":[{"name":"Bernhard-Nocht-Institut f\u00fcr Tropenmedizin, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Cadar","sequence":"additional","affiliation":[{"name":"Bernhard-Nocht-Institut f\u00fcr Tropenmedizin, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Tappe","sequence":"additional","affiliation":[{"name":"Bernhard-Nocht-Institut f\u00fcr Tropenmedizin, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Bernhard-Nocht-Institut f\u00fcr Tropenmedizin, 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