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Varicella Encephalitis

Kurt-Wolfram Sühs, Natalia Novoselova, Maike Kuhn, Lena Seegers, Volkhard Kaever, Kirsten Müller-Vahl, Corinna Trebst, Thomas Skripuletz, Martin Stangel, Frank Pessler
Background: The tryptophan-kynurenine-NAD+ pathway is closely associated with regulation of immune cells toward less inflammatory phenotypes and may exert neuroprotective effects. Investigating its regulation in CNS infections would improve our understanding of pathophysiology and end-organ damage, and, furthermore, open doors to its evaluation as a source of diagnostic and/or prognostic biomarkers. Methods: We measured concentrations of kynurenine (Kyn) and tryptophan (Trp) in 220 cerebrospinal fluid samples from patients with bacterial and viral (herpes simplex, varicella zoster, enteroviruses) meningitis/encephalitis, neuroborreliosis, autoimmune neuroinflammation (anti-NMDA-R encephalitis, multiple sclerosis), and noninflamed controls (Bell's palsy, normal pressure hydrocephalus, Tourette syndrome)...
February 5, 2019: Journal of Infectious Diseases
Ye Ji, Guo-Mei Ma, Zhi-Lei Kang, Yi Zhang, Jing-Zhe Han, Jin Li, Dan-Dan Wu, Jia Wang
RATIONALE: The coexistence of Ramsay Hunt syndrome (RHS) and varicella-zoster virus (VZV) encephalitis is rare. A patient who developed RHS after being infected with VZV, along with a pontine lesion, is reported in the present study. PATIENT CONCERNS: A 41-year-old male patient presented with his mouth askew for 7 days, and dizziness, accompanied by hearing loss for 3 days. DIAGNOSES: The patient was initially diagnosed with RHS. Brainstem encephalitis was confirmed by lumbar puncture and cerebrospinal fluid...
February 2019: Medicine (Baltimore)
Preeti A Prakash, Jingxiao Jin, Kanwal Matharu, Tanu Garg, Wendy C Tsai, Purvesh Patel, Jill E Weatherhead, Joseph S Kass
No abstract text is available yet for this article.
March 2019: Neurology® Neuroimmunology & Neuroinflammation
Nicholas L Baird, Shuyong Zhu, Catherine M Pearce, Abel Viejo-Borbolla
Varicella zoster virus (VZV) is a highly prevalent human pathogen that causes varicella (chicken pox) during primary infection and establishes latency in peripheral neurons. Symptomatic reactivation often presents as zoster (shingles), but it has also been linked to life-threatening diseases such as encephalitis, vasculopathy and meningitis. Zoster may be followed by postherpetic neuralgia, neuropathic pain lasting after resolution of the rash. The mechanisms of varicella zoster virus (VZV) latency and reactivation are not well characterized...
January 26, 2019: Viruses
Liubov I Kozlovskaya, Graciela Andrei, Alexey A Orlov, Evgeny V Khvatov, Alexander A Koruchekov, Evgeny S Belyaev, Evgeny N Nikolaev, Vladimir A Korshun, Robert Snoeck, Dmitry I Osolodkin, Elena S Matyugina, Andrey V Aralov
The phenoxazine scaffold is widely used to stabilize nucleic acid duplexes, as a part of fluorescent probes for the study of nucleic acid structure, recognition, and metabolism etc. Here we present the synthesis of phenoxazine-based nucleoside derivatives and their antiviral activity against a panel of structurally diverse viruses: enveloped DNA herpesviruses varicella zoster virus (VZV) and human cytomegalovirus, enveloped RNA tick-borne encephalitis virus (TBEV), and non-enveloped RNA enteroviruses. Studied compounds were effective against DNA and RNA viruses reproduction in cell culture...
January 23, 2019: Antiviral Research
Nicole L Sullivan, Christiane S Eberhardt, Andreas Wieland, Rama S Akondy, Jumi Yi, Anita K McElroy, Rafi Ahmed
An immunocompetent adult received corticosteroids for chest pain, which later was clinically found to be herpes zoster (HZ). She developed severe disease and rapid viral dissemination that elicited an exceptionally strong varicella zoster virus-specific B-cell and CD8 T-cell response. Clinicians should consider atypical HZ presentation prior to corticosteroid administration.
January 19, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Georg Pilz, Peter Wipfler, Ferdinand Otto, Wolfgang Hitzl, Shahrzad Afazel, Elisabeth Haschke-Becher, Eugen Trinka, Andrea Harrer
BACKGROUND: The chemokine CXCL13 is an intensively investigated biomarker in Lyme neuroborreliosis (LNB). Its role in other neuroinfections is increasingly recognized but less clear. OBJECTIVE: To determine the significance of CXCL13 in established central nervous system (CNS) infections other than LNB by matching cerebrospinal fluid (CSF) CXCL13 elevations with severity of the disease course. METHODS: We investigated 26 patients with bacterial (n = 10) and viral (n = 16; tick-borne encephalitis, n = 6; varicella zoster infection, n = 10) neuroinfections of whom CSF CXCL13 levels were available twice, from lumbar punctures (LP) performed at admission and follow-up...
January 19, 2019: Journal of Neuroinflammation
Nicole Brenner, Alexander J Mentzer, Julia Butt, Angelika Michel, Kristina Prager, Johannes Brozy, Benedikt Weißbrich, Allison E Aiello, Helen C S Meier, Judy Breuer, Rachael Almond, Naomi Allen, Michael Pawlita, Tim Waterboer
Human herpesviruses (HHV) cause a variety of clinically relevant conditions upon primary infection of typically young and immunocompetent hosts. Both primary infection and reactivation after latency can lead to more severe disease, such as encephalitis, congenital defects and cancer. Infections with HHV are also associated with cardiovascular and neurodegenerative disease. However, most of the associations are based on retrospective case-control analyses and well-powered prospective cohort studies are needed for assessing temporality and causality...
2018: PloS One
Darma Imran, Riwanti Estiasari, Kartika Maharani, Sucipto, Delly Chipta Lestari, Reyhan Eddy Yunus, Evy Yunihastuti, Teguh Haryono Karyadi, Diana Oei, Ina S Timan, Dewi Wulandari, Retno Wahyuningsih, Robiatul Adawiyah, Agnes Kurniawan, Rahmad Mulyadi, Anis Karuniawati, Ungke Anton Jaya, Dodi Safari, Arjan van Laarhoven, Bachti Alisjahbana, Sofiati Dian, Lidya Chaidir, Ahmad Rizal Ganiem, Diatri Nari Lastri, Khin Saw Aye Myint, Reinout van Crevel
Background: Little detailed knowledge is available regarding the etiology and outcome of CNS infection, particularly in HIV-infected individuals, in low-resource settings. Methods: From January 2015 to April 2016, we prospectively included all adults with suspected CNS infection in a referral hospital in Jakarta, Indonesia. Systematic screening included HIV testing, CSF examination, and neuroimaging. Results: A total of 274 patients with suspected CNS infection (median age 26 years) presented after a median of 14 days with headache (77%), fever (78%), seizures (27%), or loss of consciousness (71%)...
October 2018: Neurology. Clinical Practice
Minji Kang, Saima Aslam
Herpes zoster encephalitis (HZE) is a rare complication of varicella zoster virus (VZV) infection. We report two cases of HZE in solid organ transplant (SOT) recipients and review 10 other cases in the literature. In this review, rash was present in 67% of cases. Despite the absence of a rash, high clinical suspicion for HZE is necessary and empiric antiviral therapy should be considered. While with variable outcome, it was associated with high mortality rate of 42%. Prompt initiation of antiviral therapy remains crucial in decreasing morbidity and mortality from this fatal disease...
December 12, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Irene González, Alejandro Molina-Ortega, Pilar Pérez-Romero, Juan E Echevarría, Lante He, David Tarragó
BACKGROUND: Despite childhood universal VZV immunization was introduced in 2015, there are no data on VZV clade distribution in Spain. OBJECTIVES: To characterize the varicella-zoster virus strains circulating in Spain between 1997 and 2016. STUDY DESIGN: In this retrospective study, we determined the VZV clades in 294 patients with different pathologies (mainly encephalitis, zoster and varicella) by sequencing three fragments within ORF 22, ORF 21 and ORF 50 and, subsequently analyzing 7 relevant SNPs...
November 28, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Rujuta S Hadaye, Shruti Shastri, Sujata R Lavangare
INTRODUCTION: Immunization against vaccine-preventable diseases in adults is the need of the hour. The student nurses by virtue of training are the frontline health workers dealing with patient care. They are exposed to maximum risk of contracting the diseases. Vaccine awareness is not a part of their induction training program. It is necessary to plan preventive measure related to vaccination in their interest. AIM: This study aims to assess awareness and practices of nursing students related to adult immunization...
2018: Journal of Education and Health Promotion
Moussa Toudou-Daouda, Ahmed Filali-Adib, Aicha Slassi, Mohammed-Faouzi Belahsen, Zouhayr Souirti
OBJECTIVES: Histologically defined as an inflammation-degeneration of limbic structures, limbic encephalitis (LE) is a rare disease and often difficult to diagnose particularly in institutions with limited access to laboratory tests such as antineuronal antibodies or HSV-PCR, and functional imaging. We aimed to describe the demographic, clinical, paraclinical, and etiological features of LE, as well as its medium-term prognosis in Moroccan patients. MATERIALS AND METHODS: We collected retrospectively all patients diagnosed with LE in the Department of Neurology of the University Hospital Hassan II of Fez (Morocco) between September 2008 and December 2016...
November 25, 2018: Brain and Behavior
R I Tiwari, S S Bhullar, N H Chandak, N N Baheti, H F Daginawala, L R Singh, R S Kashyap
Viral infections of the central nervous system (CNS) occur sporadically and have been extensively studied because of the potential for permanent neurological damage or death. The neurotropic viruses have been reported to lead to various CNS infections. The objective of the present study is to develop an antigen detection ELISA protocol for detection and quantification of viral antigen in CNS infections by assessing the usefulness of antipeptide antibodies against potential peptides of cytomegalovirus (CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), Japanese encephalitis virus (JEV), dengue (DENV), West Nile virus (WNV) and Chandipura virus (CHPV)...
2018: Acta Virologica
Pavel Dyachenko, Anatoly Dyachenko, Olga Smiianova, Victoria A Kurhanskay, Ruslan Efremin
OBJECTIVE: Introduction: Herpesviruses (HVs) are ubiquitous pathogens that infect humans usually during childhood, followed by a life-long persistence in a latent state in many sites of a body including the nerve cells. After reactivation HVs can affect the Central Nervous System (CNS) becoming a major cause of morbidity and mortality worldwide as well as long-term neurological sequelae. Despite being an important public health problem very few population-based studies were conducted so far in the world and none in Ukraine...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Ruth F Itzhaki
Strong evidence has emerged recently for the concept that herpes simplex virus type 1 (HSV1) is a major risk for Alzheimer's disease (AD). This concept proposes that latent HSV1 in brain of carriers of the type 4 allele of the apolipoprotein E gene (APOE-ε4) is reactivated intermittently by events such as immunosuppression, peripheral infection, and inflammation, the consequent damage accumulating, and culminating eventually in the development of AD. Population data to investigate this epidemiologically, e...
2018: Frontiers in Aging Neuroscience
Peter G E Kennedy, Anne A Gershon
Varicella-zoster virus (VZV) is a pathogenic human herpes virus that causes varicella (chickenpox) as a primary infection, following which it becomes latent in peripheral ganglia. Decades later, the virus may reactivate either spontaneously or after a number of triggering factors to cause herpes zoster (shingles). Varicella and its complications are more severe in the immunosuppressed. The most frequent and important complication of VZV reactivation is postherpetic neuralgia, the cause of which is unknown and for which treatment is usually ineffective...
November 2, 2018: Viruses
Durga Bhandari, Prativa Pandey
INTRODUCTION: Volunteers and humanitarian aid workers working in disaster struck areas of the world are a vulnerable group of travelers. Nepal saw an influx of these humanitarian aid workers following earthquakes in April and May 2015. This study was undertaken to find out the pre-travel preparation and to estimate the risk of disease while the volunteers were deployed in Nepal. METHODS: This was a descriptive cross-sectional study conducted at CIWEC Hospital located in Kathmandu...
March 2018: JNMA; Journal of the Nepal Medical Association
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...
November 19, 2018: Medical Journal of Australia
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
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