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Encephalitis herpes virus

Lulia Koujah, Rahul K Suryawanshi, Deepak Shukla
Herpes simplex virus type-1 (HSV-1) is a ubiquitous pathogen that infects a large majority of the human population worldwide. It is also a leading cause of infection-related blindness in the developed world. HSV-1 infection of the cornea begins with viral entry into resident cells via a multistep process that involves interaction of viral glycoproteins and host cell surface receptors. Once inside, HSV-1 infection induces a chronic immune-inflammatory response resulting in corneal scarring, thinning and neovascularization...
October 16, 2018: Cellular and Molecular Life Sciences: CMLS
Miles H Beaman
Meningitis and encephalitis are medical emergencies. Patients need prompt evaluation and immediate empiric therapy to reduce the likelihood of fatal outcomes and chronic neurological sequelae. Conjugate bacterial vaccines have significantly reduced the incidence of bacterial meningitis, especially in children. As the results of changes in patterns of bacterial drug sensitivity, ceftriaxone is now part of the recommended empiric treatment for bacterial meningitis and should be administered as early as possible...
October 15, 2018: Medical Journal of Australia
Zurab Azmaiparashvili, Kevin Bryan Lo, Nawal Habib, Annie Hsieh
Valacyclovir neurotoxicity is commonly seen in the elderly and those with impaired renal function. Differential diagnosis can be challenging as a myriad of medical conditions, including herpes zoster virus associated encephalitis, may present in a similar fashion. We present a case of a 71-year-old male who presented with altered mental status in the setting of recent herpes zoster eruption. His condition was attributed to valacyclovir neurotoxicity, and initiation of appropriate supportive therapy was met with complete resolution of symptoms and normalization of cognitive function...
2018: Case Reports in Medicine
Christopher B Leahy, Sachin Mathur, Tahir Majeed
This article explains the approach to managing a patient with herpes simplex virus encephalitis. Acute encephalopathy is a common and often intimidating presentation in an acute general medical setting. Application of key principles will enable the generalist to take life-saving action before obtaining any specialist input. Viral infection is the most common cause (48.2%) of encephalitis; another large group is cases of autoimmune aetiology. Early diagnosis of encephalitis is crucial to ensure that the right treatment is given on time...
October 2, 2018: British Journal of Hospital Medicine
Aldo A Mendez, Annaliese Bosco, Lama Abdel-Wahed, Kendra Palmer, Karra A Jones, Annie Killoran
An 88-year-old man presented with a 1-month history of altered mental status and seizures. His electrographic and imaging findings were suggestive of herpes simplex encephalitis (HSE), for which he was empirically treated with acyclovir. He underwent two lumbar punctures 3 days apart; both cerebrospinal fluid analyses tested negative for herpes simplex virus (HSV) by polymerase chain reaction (PCR). These negative results and his continued deterioration after 9 days of acyclovir therapy prompted treatment with steroids for possible autoimmune encephalitis...
May 2018: Case Reports in Neurology
Kelly J Baldwin, Christopher L Cummings
PURPOSE OF REVIEW: This article reviews the spectrum of neurologic disease associated with human herpesvirus infections. RECENT FINDINGS: As more patients are becoming therapeutically immunosuppressed, human herpesvirus infections are increasingly common. Historically, infections with human herpesviruses were described as temporal lobe encephalitis caused by herpes simplex virus type 1 or type 2. More recently, however, additional pathogens, such as varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, and human herpesvirus 6 have been identified to cause serious neurologic infections...
October 2018: Continuum: Lifelong Learning in Neurology
Jennifer L Lyons
PURPOSE OF REVIEW: This article discusses meningitis and encephalitis infections caused by viruses, excluding herpes family and human immunodeficiency virus (HIV). RECENT FINDINGS: The viral infections of the nervous system detailed in this article have no specific treatment other than supportive care. However, many of the viruses discussed are highly preventable by vaccination, proper skin protection against transmitting vectors, and postexposure prophylaxis. SUMMARY: While meningitis and encephalitis caused by viruses may have some clinical overlap, the management and outcomes can be highly disparate, making distinction between the two imperative...
October 2018: Continuum: Lifelong Learning in Neurology
Jonathan D Santoro, Christopher C Hemond
BACKGROUND: Human herpesvirus 6 (HHV6) is a cause of post-transplant acute limbic encephalitis (PALE). Seizures are associated with this disorder yet no predictive biomarkers have been identified. The objective of this study was to evaluate lab and neurodiagnostic biomarkers in patients with HHV6 associated PALE. METHODS: A retrospective chart review was performed at our institutions between 2000 and 2017. Patients were identified through a clinical database. Inclusion criteria included: age less than 18 years, HHV6 (quantitative real-time PCR or meningoencephalitis panel) tested in CSF and serum...
September 26, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Karine Beiruti, Anan Abu Awad, Galina Keigler, Chen Hanna Ryder, Radi Shahien
A previously healthy 35-year-old man suffering from behavioral and mental deterioration for three months was referred to our facility. On admission, the patient was dysphasic and had tonic-clonic seizures. Neurological examination showed mental confusion, euphoric mood, mania, paranoia, and mild motor dysphasia. Magnetic resonance imaging (MRI) was performed twice but no abnormalities were revealed. His acute confusional state, elevated cerebrospinal fluid (CSF) protein, epileptic seizure and electroencephalogram showing intermittent frontal slowness were all suggestive of encephalitis...
September 26, 2018: International Journal of STD & AIDS
Paola Perini, Francesca Rinaldi, Marco Puthenparampil, Michela Marcon, Francesco Perini, Paolo Gallo
BACKGROUND: Dimethyl fumarate (DMF) is approved as first line therapy for relapsing-remitting multiple sclerosis (RRMS). In some (3%) patients, DMF induces a marked lymphopenia. Herpes simplex encephalitis (HSE) may occur in lymphopenic subjects under treatment with immune-suppressive drugs. CASE PRESENTATION: We report a case of a 39-year-old female patient with RRMS that developed HSE temporally associated with a marked and sudden drop in lymphocyte count, from 1200/µl to 600/µl, in the peripheral blood...
September 11, 2018: Multiple Sclerosis and related Disorders
Kacy A Ramirez, Asim F Choudhri, Anami Patel, Noel T Lenny, Rebecca E Thompson, Leslie Berkelhammer Greenberg, Nancy Clanton Watson, Mehmet Kocak, John P DeVincenzo
BACKGROUND: Herpes Simplex Virus encephalitis (HSVE) is a devastating disease of all ages. Rigorous studies correlating viral load with neuroradiological and clinical severity have not been performed, particularly in neonates. Understanding these relationships may improve therapies. OBJECTIVES: To correlate molecularly quantified HSV in cerebrospinal fluid (CSF) and disease severity. STUDY DESIGN: HSV loads (VL) were evaluated by real-time PCR from the CSF of 33 patients (20 neonates, 5 children, 8 adults) with HSVE...
August 18, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Mathieu Mancini, Silvia M Vidal
A majority of the world population is infected with herpes simplex viruses (HSV; human herpesvirus types 1 and 2). These viruses, perhaps best known for their manifestation in the genital or oral mucosa, can also cause herpes simplex encephalitis, a severe and often fatal disease of the central nervous system. Antiviral therapies for HSV are only partially effective since the virus can establish latent infections in neurons, and severe pathological sequelae in the brain are common. A better understanding of disease pathogenesis is required to develop new strategies against herpes simplex encephalitis, including the precise viral and host genetic determinants that promote virus invasion into the central nervous system and its associated immunopathology...
August 2018: Mammalian Genome: Official Journal of the International Mammalian Genome Society
Damla Hanalioğlu, Yasemin Özsürekci, Ayşe Büyükçam, Ayşe Gültekingil-Keser, Özlem Tekşam, Mehmet Ceyhan
Hanalioğlu D, Özsürekci Y, Büyükçam A, Gültekingil-Keser A, Tekşam Ö, Ceyhan M. Acute peripheral facial paralysis following varicella infection: An uncommon complication. Turk J Pediatr 2018; 60: 99-101. Chickenpox is caused by varicella zoster virus (VZV/HHV-3), which is one of the eight human herpes viruses. Although chickenpox has a good prognosis, neurologic complications including encephalitis, acute cerebellar ataxia, myelitis and meningitis may seldom be associated with the disease. Peripheral facial palsy (PFP) is an extremely rare complication in patients with chickenpox...
2018: Turkish Journal of Pediatrics
Coraline Canivet, Chantal Rhéaume, Manon Lebel, Jocelyne Piret, Jean Gosselin, Guy Boivin
The impact of a deficiency in interferon regulatory factor (IRF)3 and IRF7 was evaluated in an herpes simplex virus encephalitis (HSE) model. Compared to wild type (WT), the mortality rates of infected IRF3-/- and IRF7-/- mice were higher and associated with increased brain viral titers. At a critical time post-infection, IRF7-/- mice exhibited a deficit in IFN-β production. At a later time point, levels of type I IFNs and cytokines were increased in brains of both deficient mice compared to WT. Our results suggest that IRF3, and especially IRF7, are important for an effective control of inflammatory responses during HSE...
August 9, 2018: Journal of Neurovirology
I D Grice, G L Mariottini
There remains today a critical need for new antiviral agents, particularly in view of the alarming increase in drug resistance and associated issues. The marine environment has been a prolific contributor towards the identification of novel therapeutic agents in the recent few decades. Added to this, glycans (or carbohydrate- or sugar-based compounds) have in very recent decades made outstanding contributions to the development of novel therapeutics. This review brings together these significant facets of modern drug discovery by presenting the reported literature on glycans derived from marine organisms that possess antiviral activity...
2018: Results and Problems in Cell Differentiation
Katia Perruccio, Luisa Sisinni, Antonio Perez-Martinez, Jaime Valentin, Ilaria Capolsini, Maria Speranza Massei, Maurizio Caniglia, Simone Cesaro
Human herpesvirus-6 (HHV-6) infection is increasingly recognized among allogeneic hematopoietic stem cell transplantation (HSCT) recipients, with 30% at risk of reactivation in the haploidentical setting. It has been associated with encephalitis, acute graft-versus-host disease, and graft failure. Here we report 2 cohorts of pediatric haploidentical manipulated HSCT in which, despite many differences, HHV-6 reactivation and disease occurred with very high incidence compared with data reported in the literature and represented the main early post-transplant infectious complication compared with other viral, bacterial, or fungal infections...
July 29, 2018: Biology of Blood and Marrow Transplantation
Arun Chaudhury, Vijaya Sena Reddy Dendi, Mousumi Chaudhury, Astha Jain, Madhukar Reddy Kasarla, Kiran Panuganti, Gaurav Jain, Abhijit Ramanujam, Bhavin Rena, Sudheer Reddy Koyagura, Sumit Fogla, Sunil Kumar, Nawal Singh Shekhawat, Srinivas Maddur
In an interesting investigation by Khoury-Hanold et al. (1), genital infection of mice with herpes simplex virus 1 (HSV1) were reported to cause multiple pelvic organ involvement and obstruction. A small subset of mice succumbed after the first week of HSV1 infection. The authors inferred that the mice died due to toxic megacolon. In a severe form of mechanical and/or functional obstruction involving gross dilation of the colon and profound toxemia, the presentation is called "toxic megacolon." The representative observations by Khoury-Hanold likely do not resemble toxic megacolon...
2018: Frontiers in Medicine
Alessandro Feola, Anna Mancuso, Mauro Arcangeli
We present a case of herpes simplex virus-1 encephalitis (HSVE) and discuss the difficulty of early diagnosis and the possibility of a wrong or delayed diagnosis and treatment of this encephalitis. We show the importance of considering HSVE to pursue every case of suspicious medical liability.
2018: Case Reports in Medicine
Thaís Armangue, Marianna Spatola, Alexandru Vlagea, Simone Mattozzi, Marc Cárceles-Cordon, Eloy Martinez-Heras, Sara Llufriu, Jordi Muchart, María Elena Erro, Laura Abraira, German Moris, Luis Monros-Giménez, Íñigo Corral-Corral, Carmen Montejo, Manuel Toledo, Luis Bataller, Gabriela Secondi, Helena Ariño, Eugenia Martínez-Hernández, Manel Juan, Maria Angeles Marcos, Laia Alsina, Albert Saiz, Myrna R Rosenfeld, Francesc Graus, Josep Dalmau
BACKGROUND: Herpes simplex encephalitis can trigger autoimmune encephalitis that leads to neurological worsening. We aimed to assess the frequency, symptoms, risk factors, and outcomes of this complication. METHODS: We did a prospective observational study and retrospective analysis. In the prospective observational part of this study, we included patients with herpes simplex encephalitis diagnosed by neurologists, paediatricians, or infectious disease specialists in 19 secondary and tertiary Spanish centres (Cohort A)...
September 2018: Lancet Neurology
Tehmina Bharucha, Hadi Manji
'The world is a book and those who do not travel read only one page'.Augustine of Hippo - Latin philosopher and theologian.Neurological presentations are seen in about 1.5%-2.0% of returning travellers seeking medical attention, and may pose a particular challenge to diagnose and treat. These may be severe and life threatening, such as meningoencephalitic illnesses or inflammatory radiculoneuropathy (Guillain-Barré-like) syndromes requiring intensive care support. It is essential not to miss the potentially treatable and common diseases such as malaria, which can be lethal if undiagnosed...
October 2018: Practical Neurology
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