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Herpes simplex encephalitis In childrens

Tam T Van, Kanokporn Mongkolrattanothai, Melissa Arevalo, Maryann Lustestica, Jennifer Dien Bard
Herpes simplex virus (HSV) infection of the central nervous system (CNS) is associated with significant morbidity and mortality in children. This study assessed the impact of a direct HSV (dHSV) PCR assay on time to result and duration of acyclovir therapy in children with signs and symptoms of meningitis and encephalitis. A total of 363 patients with HSV PCR on CSF were included in this retrospective analysis, divided into the pre- and post-implementation groups. The pre-implementation arm included CSF testing performed using a laboratory-developed real-time PCR assay and the post-implementation group consisted of CSF samples tested using a direct sample-to-answer assay...
March 8, 2017: Journal of Clinical Microbiology
Romain Guedj, Hélène Chappuy, Luigi Titomanlio, Loic De Pontual, Sandra Biscardi, Gisèle Nissack-Obiketeki, Béatrice Pellegrino, Oussama Charara, François Angoulvant, Julien Denis, Corinne Levy, Robert Cohen, Solène Loschi, Pierre Louis Leger, Ricardo Carbajal
STUDY OBJECTIVE: We assess the prevalences of bacterial meningitis and herpes simplex virus meningoencephalitis (HSV-ME) in children with a complex febrile seizure and determine these prevalences in the subgroup of children with a clinical examination result not suggestive of meningitis or encephalitis. METHODS: This multicenter retrospective study was conducted in 7 pediatric emergency departments (EDs) in the region of Paris, France. Visits of patients aged 6 months to 5 years for a complex febrile seizure from January 2007 to December 2011 were analyzed...
March 1, 2017: Annals of Emergency Medicine
John W Gnann, Richard J Whitley
PURPOSE OF REVIEW: The goal of this review is to provide an update on current thinking regarding herpes simplex encephalitis (HSE), emphasizing new information about pathogenesis, diagnosis, and immune responses. Specific questions to be addressed are the following: (1) Is there a genetic predisposition to HSE? (2) What clinical approaches have the greatest impact on improving the long-term outcomes in patients with HSE? And (3) are there immune-mediated mechanisms that may account for relapsing HSE? RECENT FINDINGS: Toll-like receptor 3 (TLR 3) plays an important role in innate immune responses, including generation of interferons...
March 2017: Current Infectious Disease Reports
Marianna Spatola, Mar Petit-Pedrol, Mateus Mistieri Simabukuro, Thaís Armangue, Fernanda J Castro, Maria I Barcelo Artigues, Maria R Julià Benique, Leslie Benson, Mark Gorman, Ana Felipe, Ruben L Caparó Oblitas, Myrna R Rosenfeld, Francesc Graus, Josep Dalmau
OBJECTIVE: To report the clinical features, comorbidities, receptor subunit targets, and outcome in patients with anti-GABAA receptor (GABAAR) encephalitis. METHODS: Clinical study of 26 patients, including 17 new (April 2013-January 2016) and 9 previously reported patients. Antibodies to α1, β3, and γ2 subunits of the GABAAR were determined using reported techniques. RESULTS: Patients' median age was 40.5 years (interquartile range 48...
March 14, 2017: Neurology
Ngan T K Pham, Hiroshi Ushijima, Aksara Thongprachum, Quang D Trinh, Pattara Khamrin, Chikako Arakawa, Wakako Ishii, Shoko Okitsu, Shihoko Komine-Aizawa, Satoshi Hayakawa
BACKGROUND: Acute encephalitis is a serious neurological condition having a high mortality rate and affecting both children and adults. This study aimed to develop a multiplex PCR method for the simultaneous screening of clinical samples for the presence of the 10 viruses presently considered as the major viral causes of acute encephalitis/ encephalopathy in Asia. METHODS: Using previously published primers that have been widely used to screen for herpes virus-6, influenza A virus, human parechovirus, herpes simplex viruses 1 and 2, Japanese encephalitis virus, group A rotavirus, enterovirus, adenovirus, and dengue virus in clinical samples, a single-tube multiplex PCR assay was developed and was tested for its sensitivity and specificity...
January 1, 2017: Clinical Laboratory
Kerstin Hellgren, Åsa Fowler, Agneta Rydberg, Ronny Wickström
PURPOSE: To evaluate ophthalmological abnormalities in children with acute encephalitis. METHODS: Thirty-six children included in a hospital-based prospectively and consecutively collected cohort of children with acute encephalitis were investigated for ophthalmological abnormalities. The investigation included clinical ophthalmological examination, fundus photography, neuro-ophthalmological examinations as well as visual and stereo acuity. Results on laboratory examinations, clinical findings, neuroimaging and electroencephalography registrations were recorded for all children...
February 2017: Acta Ophthalmologica
Hülya Maraş Genç, Emek Uyur Yalçın, Murat Sayan, Asuman Bayhan, Selim Öncel, Emin Sami Arısoy, Bülent Kara
BACKGROUND: Herpes simplex virus encephalitis (HSE) is a significant cause of morbidity and mortality. Neurologic sequelae are common even after early initiation of acyclovir treatment. The host immune response during HSE can also lead to brain damage. There are an increasing number of reports favoring steroid use in HSE. OBJECTIVES: We aimed to compare the prognosis of children with HSE with and without steroid therapy. STUDY DESIGN: We retrospectively screened our hospital archive from 2009 to 2014 for patients diagnosed with HSE with a positive result for herpes simplex virus polymerase chain reaction in cerebrospinal fluid...
July 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Dusan Bogunovic
In most children and adults, primary infection with herpes simplex virus 1 (HSV-1) is asymptomatic. However, very rarely (incidence of 1 in 1,000,000), it can cause herpes simplex encephalitis (HSE). HSE also occurs in infants but with a much starker incidence of one in three. This age difference in susceptibility to HSV-1-caused HSE is not well understood. In a recent article in mBio, authors have identified the choroid plexus as the anatomical site of robust HSV-1 replication in the brain. They point to low levels of type I interferon (IFN) receptor as causal of the lack of HSV-1 replication control in neonates, in contrast to adults...
2016: MBio
Himanshu Gupta, Pushwinder Dhunputh, Ankita N Bhatt, Kapaettu Satyamoorthy, Shashikiran Umakanth
Cerebral malaria (CM) is a diffuse encephalopathy associated with coma and seizures commonly caused by Plasmodium falciparum (P. falciparum) in children with severe malaria. We present a case of a 19-year-old man with CM due to Plasmodium vivax (P. vivax) infection. Cerebrospinal fluid (CSF) was negative for Japanese B encephalitis, enterovirus, herpes simplex 1 and 2, varicella and mumps viruses as determined by real-time polymerase chain reaction (PCR). P. falciparum and P. vivax species were analysed by microscopy, immunochromatography and PCR assays and confirmed mono-infection of P...
October 2016: Tropical Doctor
Mahdi Paryan, Samira Mohammadi-Yeganeh, Houri Rezvan, Vahid Kia, Ardalan Mansouri, Siamak Mirab Samiee
Herpes simplex virus (HSV) is a human pathogen that causes different pathologic manifestations. Rapid and feasible detection and discrimination methods for HSV genotyping is a challenge in clinical laboratories, especially in children suffering from herpetic encephalitis. A quantitative real-time polymerase chain reaction (PCR)-based genotyping assay using SYBR Green I was established. We designed only 1 pair of primer for HSV 1 and 2, targeting thymidine kinase gene conserved region. HSV genotypes were determined by PCR using melting curve analysis with LightCycler...
February 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
Silke Vollbach, Andreas Müller, Jan Felix Drexler, Arne Simon, Christian Drosten, Anna Maria Eis-Hübinger, Marcus Panning
BACKGROUND: Human enterovirus (EV) and parechovirus (HPeV) are significant causes of encephalitis and meningitis in children. The aim of this study was to determine the prevalence, type and viral RNA concentration of EV and HPeV in cerebrospinal fluid (CSF) samples in an unselected cohort of patients <18 years admitted to Bonn university hospital from 1998 to 2008. METHODS: A total of 327 CSF samples from 327 patients were retrospectively tested by real-time reverse-transcriptase PCR (RT-PCR) for EV and HPeV, and by real-time PCR for cytomegalovirus (CMV), herpes simplex virus 1/2 (HSV), and varizella zoster-virus (VZV)...
2015: Virology Journal
N Mørk, E Kofod-Olsen, K B Sørensen, E Bach, T F Ørntoft, L Østergaard, S R Paludan, M Christiansen, T H Mogensen
Herpes simplex encephalitis (HSE) in children has previously been linked to defects in type I interferon production downstream of Toll-like receptor (TLR)3. In the present study, we used whole-exome sequencing to investigate the genetic profile of 16 adult patients with a history of HSE. We identified novel mutations in IRF3, TYK2 and MAVS, molecules involved in generating innate antiviral immune responses, which have not previously been associated with HSE. Moreover, data revealed mutations in TLR3, TRIF, TBK1 and STAT1 known to be associated with HSE in children but not previously described in adults...
December 2015: Genes and Immunity
José Tomás, Maria Carmo Macário, Elsa Gaspar, Isabel Santana
Neurological complications of H1N1 infections are mostly found in children, but rare cases of acute encephalopathy and post-infectious encephalitis such as acute disseminated encephalomyelitis (ADEM) have been described in adults. We report a case of an adult presenting with a progressive and severe encephalopathy that developed after H1N1 respiratory infection resolution. Cerebrospinal fluid (CSF) analysis was normal, including negative PCR for herpes simplex virus, H1N1, influenza B and JC virus, and absent oligoclonal IgG bands in CSF and serum...
October 22, 2015: BMJ Case Reports
Thaís Armangue, Germán Moris, Verónica Cantarín-Extremera, Carlos Enrique Conde, Kevin Rostasy, Maria Elena Erro, Juan Carlos Portilla-Cuenca, Eulàlia Turón-Viñas, Ignacio Málaga, Beatriz Muñoz-Cabello, Carmen Torres-Torres, Sara Llufriu, Luis González-Gutiérrez-Solana, Guillermo González, Ignacio Casado-Naranjo, Myrna Rosenfeld, Francesc Graus, Josep Dalmau
OBJECTIVE: To report 14 patients with immune-mediated relapsing symptoms post-herpes simplex encephalitis (HSE) and to compare the clinical and immunologic features of the teenage and adult group with those of young children. METHODS: Prospective observational study of patients diagnosed between June 2013 and February 2015. Immunologic techniques have been reported previously. RESULTS: Among the teenage and adult group (8 patients, median age 40 years, range 13-69; 5 male), 3 had an acute symptom presentation suggesting a viral relapse, and 5 a presentation contiguous with HSE suggesting a recrudescence of previous deficits...
November 17, 2015: Neurology
Philip N Britton, Lynette Khoury, Robert Booy, Nicholas Wood, Cheryl A Jones
OBJECTIVE: The clinical epidemiology of childhood encephalitis in Australia is inadequately understood. We aimed to describe recent trends in childhood encephalitis-related hospitalisation. STUDY DESIGN: We identified encephalitis-related hospital admissions (2000-2012) in national datasets among children ≤14 years using ICD encephalitis codes. We calculated hospitalisation rates and analysed trends by year, age, gender, location, indigenous status and aetiology...
January 2016: Archives of Disease in Childhood
Line Lykke Andersen, Nanna Mørk, Line S Reinert, Emil Kofod-Olsen, Ryo Narita, Sofie E Jørgensen, Kristian A Skipper, Klara Höning, Hans Henrik Gad, Lars Østergaard, Torben F Ørntoft, Veit Hornung, Søren R Paludan, Jacob Giehm Mikkelsen, Takashi Fujita, Mette Christiansen, Rune Hartmann, Trine H Mogensen
Herpes simplex encephalitis (HSE) in children has previously been linked to defects in type I interferon (IFN) production downstream of Toll-like receptor 3. Here, we describe a novel genetic etiology of HSE by identifying a heterozygous loss-of-function mutation in the IFN regulatory factor 3 (IRF3) gene, leading to autosomal dominant (AD) IRF3 deficiency by haploinsufficiency, in an adolescent female patient with HSE. IRF3 is activated by most pattern recognition receptors recognizing viral infections and plays an essential role in induction of type I IFN...
August 24, 2015: Journal of Experimental Medicine
Murat Sutcu, Hacer Akturk, Ayper Somer, Burak Tatli, Selda Hancerli Torun, Edibe Pembegul Yıldız, Guntulu Şık, Agop Citak, Ali Agacfidan, Nuran Salman
Post-herpes simplex virus encephalitis relapses have been recently associated with autoimmunity driven by autoantibodies against N-methyl-d-aspartate (NMDA) receptors. Because it offers different treatment options, determination of this condition is important. Between 2011 and 2014, 7 children with proven diagnosis of herpes simplex virus encephalitis were identified in a university hospital of Istanbul. Two patients had neurologic relapse characterized mainly by movement disorders 2 to 3 weeks after initial encephalitis...
March 2016: Journal of Child Neurology
Nili Yanai Milshtein, Gideon Paret, Shimon Reif, Ora Halutz, Galia Grisaru-Soen
OBJECTIVES: The clinical characteristics, pathogens, and outcome were analyzed to investigate the etiology of acute pediatric encephalitis in 2 tertiary pediatric medical centers in Israel. METHODS: A retrospective study among children aged 1 month to 18 years hospitalized with the diagnosis of acute encephalitis between January 1999 and December 2009. Data on presenting symptoms, clinical findings, microbiological, virologic, electroencephalographic and neuroimaging studies, laboratory results, and hospital course were retrieved from the medical records and the computerized microbiology database...
February 2016: Pediatric Emergency Care
Nicholas A Morris, Tamara B Kaplan, Jenny Linnoila, Tracey Cho
Herpes simplex virus (HSV) encephalitis can induce an autoimmune encephalitis mediated by autoantibodies against the N-methyl-D-aspartate receptor (NMDAR). Post-HSV NMDAR encephalitis and de novo NMDAR encephalitis have been more commonly described in children and young adults. We describe the case of a 67-year-old woman with post-HSV NMDAR encephalitis and review the relevant literature. Clinical, serological, neurophysiological, and imaging evaluations were undertaken in the evaluation of this patient. A literature review was performed...
February 2016: Journal of Neurovirology
Laura Silveira-Moriyama, Jean-Pierre Lin
PURPOSE OF REVIEW: Recent advances in neurogenetics, neuroimmunology and nonpharmacological treatments have reshaped the field of paediatric movement disorders. In this review, we put recent findings into context providing a framework to enable navigation of the expanding literature in this field. RECENT FINDINGS: Anti-NMDA receptor encephalitis has proven to be a significant cause of treatable movement disorder in children and to present a multifaceted link with herpes simplex encephalitis...
August 2015: Current Opinion in Neurology
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