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Hhv6 encephalitis

Hasip Kahraman, Alper Tünger, Şebnem Şenol, Hörü Gazi, Meltem Avcı, Bahar Örmen, Nesrin Türker, Sabri Atalay, Şükran Köse, Sercan Ulusoy, Meltem Işıkgöz Taşbakan, Oğuz Reşat Sipahi, Tansu Yamazhan, Zeynep Gülay, Sema Alp Çavuş, Hüsnü Pullukçu
In this multicenter prospective cohort study, it was aimed to evaluate the bacterial and viral etiology in community-acquired central nervous system infections by standart bacteriological culture and multiplex polymerase chain reaction (PCR) methods. Patients hospitalized with central nervous system infections between April 2012 and February 2014 were enrolled in the study. Demographic and clinical information of the patients were collected prospectively. Cerebrospinal fluid (CSF) samples of the patients were examined by standart bacteriological culture methods, bacterial multiplex PCR (Seeplex meningitis-B ACE Detection (Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes, Group B streptococci) and viral multiplex PCR (Seeplex meningitis-V1 ACE Detection kits herpes simplex virus-1 (HSV1), herpes simplex virus-2 (HSV2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV) and human herpes virus 6 (HHV6)) (Seeplex meningitis-V2 ACE Detection kit (enteroviruses))...
July 2017: Mikrobiyoloji Bülteni
Kei Takasawa, Ryuichi Nakagawa, Shigeru Takishima, Kengo Moriyama, Ken Watanabe, Koji Kiyohara, Takeshi Hasegawa, Masahiro Shimohira, Kenichi Kashimada, Norio Shimizu, Tomohiro Morio
BACKGROUND: Acute encephalitis/encephalopathy (AE/E) is a rare and severe complication of common childhood infections; however, a treatment strategy based on clinical and pathological evidence has not been established. METHODS: The clinical data and aetiological results using a rapid and comprehensive virological detection system of 62 Japanese children diagnosed with AE/E from 2010 to 2014 were collected. We assessed clinical differences between causes and effectiveness of our multiplex PCR system to establish a pathogen-based treatment strategy for AE/E...
February 2018: Brain & Development
Ayşın Zeytinoğlu, Selda Erensoy, Rüçhan Sertöz, İmre Altuğlu, Candan Çiçek, Münevver Kayın, Hadiye Şirin, Şafak Taner
The serious diseases of the central nervous system (CNS); encephalitis and meningitis, have high mortality and morbidity rate especially not diagnosed and treated in time. Nucleic acid testing (NAT) is the tool of choice for viral diagnosis in CNS infections. In this study, viral etiological agents found in cerebrospinal fluid (CSF) samples sent to our university hospital virology laboratory for laboratory diagnosis of CNS infections were retrospectively evaluated and results were compared with other reports from our country...
April 2017: Mikrobiyoloji Bülteni
A Bertrand, D Leclercq, L Martinez-Almoyna, N Girard, J-P Stahl, T De-Broucker
BACKGROUND: Imaging is a key tool for the diagnosis of acute encephalitis. Brain CT scan must be urgently performed to rule out a brain lesion with mass effect that would contraindicate lumbar puncture. Brain MRI is less accessible than CT scan, but can provide crucial information with patients presenting with acute encephalitis. METHOD: We performed a literature review on PubMed on April 1, 2015 with the search terms "MRI" and "encephalitis"...
May 2017: Médecine et Maladies Infectieuses
Raffaella Greco, Lara Crucitti, Maddalena Noviello, Sara Racca, Daniele Mannina, Alessandra Forcina, Francesca Lorentino, Veronica Valtolina, Serena Rolla, Roee Dvir, Mara Morelli, Fabio Giglio, Maria Chiara Barbanti, Maria Teresa Lupo Stanghellini, Chiara Oltolini, Luca Vago, Paolo Scarpellini, Andrea Assanelli, Matteo G Carrabba, Sarah Marktel, Massimo Bernardi, Consuelo Corti, Massimo Clementi, Jacopo Peccatori, Chiara Bonini, Fabio Ciceri
Human herpesvirus 6 (HHV-6) is increasingly recognized as a potentially life-threatening pathogen in allogeneic hematopoietic stem cell transplantation (alloSCT). We retrospectively evaluated 54 adult patients who developed positivity to HHV-6 after alloSCT. The median time from alloSCT to HHV-6 reactivation was 34 days. HHV-6 was present in plasma samples from 31 patients, in bone marrow (BM) of 9 patients, in bronchoalveolar lavage fluid and liver or gut biopsy specimens from 33 patients, and in cerebrospinal fluid of 7 patients...
December 2016: Biology of Blood and Marrow Transplantation
Klára Labská, Kateřina Roubalová, Dušan Pícha, Vilma Marešová
Reactivation of HHVs in the CNS due to inflammation has not been well described yet. The primary aim of this study was to investigate the frequency of HHV DNA detection in the cerebrospinal fluid (CSF) of immunocompetent patients with meningoencephalitis of other than HHV origin. The secondary aim of this study was to evaluate the impact of herpesvirus co-infection on the clinical course and patient outcome. Ninety-six patients with clinically and laboratory proven tick-borne encephalitis (TBE) and 77 patients with a confirmed diagnosis of enteroviral meningitis (EVM), along with a control group of 107 patients without evidence of inflammation in the CSF were retrospectively tested by nested PCR for the presence of DNA of the neurotropic herpesviruses HSV1, HSV2, VZV, and HHV6 in the CSF...
July 2015: Journal of Medical Virology
Zsila Sadighi, Noah D Sabin, Randall Hayden, Elizabeth Stewart, Asha Pillai
Human herpesvirus 6 (HHV6) encephalitis and Wernicke encephalopathy are treatable yet frequently undiagnosed causes of encephalopathy in pediatric recipients of allogeneic and autologous hematopoietic cell transplantation. Here we review representative cases of both conditions to highlight specific and relevant neurologic features that prompted effective diagnosis and treatment. Two patients with confusion accompanied by seizures, memory changes, or specific visual hallucinations and HHV6 detectable by polymerase chain reaction (PCR) in cerebrospinal fluid had improvement in viral load with ganciclovir or foscarnet treatment...
September 2015: Journal of Child Neurology
Jukka Hytönen, Elisa Kortela, Matti Waris, Juha Puustinen, Jemiina Salo, Jarmo Oksi
BACKGROUND: Laboratory diagnosis of Lyme neuroborreliosis (LNB) is partly based on the detection of intrathecal Borrelia burgdorferi-specific antibody production (increased antibody index (AI)). However, AI can be negative in patients with early LNB and, conversely, can remain elevated for months after antibiotic treatment. Recent studies suggested that the chemokine CXCL13 in the cerebrospinal fluid (CSF) is a biomarker for active LNB. Also, CSF neopterin-level determination has been used to assess the degree of neuroinflammation in a wide variety of diseases...
2014: Journal of Neuroinflammation
Shinichiro Kawamoto, Kazuo Hatanaka, Masami Imakita, Toshiharu Tamaki
A 60-year-old myelodysplastic syndrome patient underwent tandem cord blood transplantation. The primary cord blood graft was rejected, and human herpesvirus 6 (HHV6) encephalitis developed after engraftment of secondary cord blood. Polyuria and adipsic hypernatremia were observed during treatment of the encephalitis. The patient died of bacteremia caused by methicillin-resistant Streptococcus epidermis. HHV6 infection in the posterior pituitary was confirmed on autopsy, as was infection of the hippocampus, but not of the hypothalamus...
2013: Internal Medicine
Miquel Raspall-Chaure, Thaís Armangué, Izaskun Elorza, Angel Sanchez-Montanez, Mònica Vicente-Rasoamalala, Alfons Macaya
Generalised epilepsy and cognitive deterioration were recently described in three children following human herpesvirus 6 (HHV6)-associated post-transplant acute limbic encephalitis (PALE). Magnetic resonance imaging (MRI) showed bilateral signal change and/or atrophy in the medial temporal structures and there was no evidence of an ongoing viral or immune-mediated process. We report another child who developed this condition after cord blood transplantation for congenital neutropenia at the age of three. He presented with epileptic spasms four months after HHV6-associated PALE...
August 2013: Epilepsy Research
E Bozzola, A Krzysztofiak, M Bozzola, V Calcaterra, A Quondamcarlo, L Lancella, A Villani
INTRODUCTION: Human herpes virus 6 (HHV6) infection is a self-limiting illness occurring in early childhood. As with other herpes viruses, the encephalopathy associated with HHV6 is often attributable to the reactivation of a virus previously latent in human brain tissue. Previous reports on HHV6 encephalopathy dealt mainly with virus reactivation in immune-depressed older children and, above all, refer to encephalitis and not to meningoencephalitis. Complications are rare in healthy children...
October 2012: Infection
Mitsutaka Nishimoto, Hirohisa Nakamae, Yoshiki Hayashi, Hideo Koh, Takahiko Nakane, Masahiro Yoshida, Masato Bingo, Hiroshi Okamura, Mizuki Aimoto, Satoru Nanno, Takuro Yoshimura, Akiko Inaba, Kiyoyuki Hagihara, Mika Nakamae, Asao Hirose, Yoshitaka Nakao, Yoshiki Terada, Masayuki Hino
A 19-year-old man with Philadelphia chromosome-positive acute lymphoblastic leukemia received an allogeneic hematopoietic cell transplant with unrelated bone marrow. On day 20, the patient developed impaired consciousness and disorientation. Examination of the cerebrospinal fluid showed 2×10(4) copies/mL of HHV6B. HHV6 encephalitis was diagnosed, as had HHV6 myelitis based on symptoms that included lancinating pain/pruritus in the lower limbs and dysuria/dyschezia. Concurrently, he showed sinus tachycardia...
2012: Internal Medicine
Sudathip Paticheep, Subsai Kongsaengdao
Viral infection of central nervous system (CNS) is a common problem worldwide, especially in children. The clinical manifestations of viral CNS infection are the most important clues for diagnosis and treatment. The 1-year prospective study to explore the prevalence, clinical manifestations, and laboratory findings of viral CNS infection in children, including human herpes virus (HHV) type 1, 2, 3, 4, 5, 6A, 6B, 7, enterovirus B, mumps virus, measles virus, Japanese encephalitis virus, JC virus, BK polyomavirus, Nipha virus and influenza virus (H1N1, H3N2) were performed...
December 2011: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Katherine B Howell, Karin Tiedemann, Gabrielle Haeusler, Mark T Mackay, Andrew J Kornberg, Jeremy L Freeman, A Simon Harvey
Human herpesvirus 6 (HHV6) is the major cause of posttransplant acute limbic encephalitis (PALE) in immunosuppressed patients following hematopoietic stem cell transplant. Memory impairment and temporal lobe epilepsy following PALE are reported in adults, but sequelae in young children are unknown. We report three children with HHV6-associated PALE 20-23 days after cord blood transplantation for leukemias who developed symptomatic generalized epilepsy. Patients were followed for 2-8 years and underwent magnetic resonance imaging (MRI) and video-electroencephalography (EEG)...
July 2012: Epilepsia
Burk Jubelt, Cornelia Mihai, Terrence M Li, Padma Veerapaneni
Rhombencephalitis (RE) is a syndrome of multiple causes and multiple outcomes. Most authors now use the terms "rhombencephalitis" and "brainstem encephalitis" interchangeably even though anatomically they are slightly different. The etiologic categories of RE include infections, autoimmune diseases, and paraneoplastic syndromes (PNS). Listeria is the most common cause of infectious RE. Listeria RE primary occurs in healthy young adults. It usually occurs as a biphasic time course with a flu-like syndrome followed by brainstem dysfunction; 75% of patients have a cerebrospinal fluid (CSF) pleocytosis, and almost 100% have an abnormal brain MRI scan...
December 2011: Current Neurology and Neuroscience Reports
Masashi Shiomi
Many aspects of the pathogenesis of acute encephalitis and acute encephalopathy have been clarified in this decade, although many unknown mechanisms remain to be elucidated. According to progress of MRI and neuroimmunological analysis and the observation of clinical findings, many new syndromes were found, which enhanced our understanding of acute encephalitis and acute encephalopathy. The pathogenesis of encephalitis is divided into infection and immune mediated mechanisms. The antibodies to neuronal surface antigens(NSA) such as NMDA receptors, leucin-rich glioma inactivated 1 (LGI1) and aquaporin 4 were demonstrated in specific encephalitis, limbic encephalitis and neuromyelitis optica...
March 2011: Nihon Rinsho. Japanese Journal of Clinical Medicine
U Reischl, B Kochanowski
The polymerase chain reaction (PCR) is a powerful tool for the amplification of trace amounts of nucleic acids, and has rapidly become an essential analytical tool for virtually all aspects of biological research in experimental biology and medicine. Because the application of this technique provides unprecedented sensitivity, it has facilitated the development of a variety of nucleic acid-based systems for diagnostic purposes, such as the detection of viral (1) or bacterial pathogens (2), as well as genetic disorders (3), cancer (4), and forensic analysis (5)...
1999: Methods in Molecular Medicine
E Jaskula, D Dlubek, M Sedzimirska, D Duda, A Tarnowska, A Lange
One hundred two recipients of hematopoietic stem cell transplants (HSCTs) 45, from siblings and 57 from matched unrelated donors, were followed for cytomegalovirus (CMV), human herpes virus (HHV) 6, and Epstein-Barr Virus (EBV) reactivation by quantitative polymerase chain reaction in the context of immunologic reconstitution and posttransplantation complications. CMV, EBV, and HHV6 DNA copies (>100 copies/10(5) cells) were detected in 34%, 27%, and 26% of patients, respectively. The presence of 100 copies of EBV or CMV was associated with posttransplant complications: 29/66 versus 6/36 (P<...
October 2010: Transplantation Proceedings
Yasuo Mori, Toshihiro Miyamoto, Koji Nagafuji, Kenjiro Kamezaki, Asataro Yamamoto, Noriyuki Saito, Koji Kato, Katsuto Takenaka, Hiromi Iwasaki, Naoki Harada, Yasunobu Abe, Takanori Teshima, Koichi Akashi
Human herpes virus (HHV)6-associated limbic encephalitis and/or myelitis is one of the life-threatening central nervous system complications following allogeneic hematopoietic stem cell transplantation (HSCT). Recent reports have shown significant correlations of these complications with unrelated cord blood transplantation (UCBT). We retrospectively analyzed 228 allogeneic HSCT recipients in our single institution; 13 patients (5.7%) were diagnosed with HHV6-associated encephalitis/myelitis. This complication was documented in 8 of 51 UCBT recipients (15...
November 2010: Biology of Blood and Marrow Transplantation
Kenneth L Tyler
In this 2-part review, I will focus on emerging virus infections of the central nervous system (CNS). Part 1 will introduce the basic features of emerging infections, including their definition, epidemiology, and the frequency of CNS involvement. Important mechanisms of emergence will be reviewed, including viruses spreading into new host ranges as exemplified by West Nile virus (WNV), Japanese encephalitis (JE) virus, Toscana virus, and enterovirus 71 (EV71). Emerging infections also result from opportunistic spread of viruses into known niches, often resulting from attenuated host resistance to infection...
August 2009: Archives of Neurology
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