Diagnosing viral encephalitis and emerging concepts

Yong, Heather Y.F.; Pastula, Daniel M.; Kapadia, Ronak K.

doi:10.1097/wco.0000000000001155

Cited by 7 publications

(2 citation statements)

References 104 publications

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“…53 Patients presenting with a skin rash warrant an investigation into viral encephalitis-associated inflammation causes, with a particular focus on varicella infection during the diagnostic process. 54 Essential factors in assessing mpox infection include a patient's travel history to Africa or exposure to exotic pets.…”

Section: Management Diagnostic Tests and Treatmentmentioning

confidence: 99%

Overview of reemerging mpox infection with a focus on neurological manifestations

Alissa,

Alghamdi,

Alghamdi

2024

Reviews in Medical Virology

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Mpox, a reemerging zoonotic disease caused by the mpox virus, has garnered increasing attention due to its potential for severe clinical manifestations. While the cutaneous and systemic presentations of mpox have been well‐documented, its neurological complications have recently emerged as an area of concern. This review provides a brief overview of the neurological aspects of mpox infection, highlighting the key findings and challenges in understanding and managing these complications. Neurological manifestations in mpox patients range from mild symptoms such as headaches and dizziness to more severe conditions, including encephalitis and seizures. The pathogenesis of neurological involvement is not yet fully elucidated but is thought to involve viral dissemination to the central nervous system. This dissemination may occur through haematogenous or neuronal routes, contributing to the diverse clinical spectrum observed. Early recognition and diagnosis of neurological complications in mpox are crucial for implementing appropriate therapeutic interventions and improving patient outcomes.

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Section: Management Diagnostic Tests and Treatmentmentioning

confidence: 99%

Overview of reemerging mpox infection with a focus on neurological manifestations

Alissa,

Alghamdi,

Alghamdi

2024

Reviews in Medical Virology

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“…Both are potentially serious health conditions requiring early and accurate diagnosis [1]. However, neurological signs and symptoms can be subtle or atypical, especially in children, thus implicating diagnostic challenges [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Closing the Diagnostic Gap in Encephalitis and Acute Disseminated Encephalomyelitis through Digital Case Classification and Viral Metagenomics

Obermeier,

Ma,

Heim

et al. 2024

Microbiology Research

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Encephalitis and acute disseminated encephalomyelitis (ADEM) are often caused or triggered by viruses—but the specific pathogen commonly remains unidentified in routine care. We explored the use of viral metagenomic next-generation sequencing (mNGS) in addition to PCR testing of non-invasive stool samples to see if unbiased testing could potentially increase diagnostic yield. To identify specific clinical cases at the point of care, we took advantage of a previously published digital app allowing instant clinical case classification based on consensus case criteria, the VACC-Tool. This hospital-based prospective digital surveillance program assessed 100 pediatric patients (mean age: 11 years, range: 0.15–17.85; 49% male) with case-confirmed encephalitis and/or ADEM. Analysis of case classification at the point of care revealed that in routine care, 96% of confirmed encephalitis/ADEM cases had been missed. Overall agreement of routine care diagnoses with digital encephalitis/ADEM case classification was <50%. Also in routine care, only 13% of cases held a virus-related diagnosis, i.e., herpesvirus (n = 8) and enterovirus infection (n = 5). Use of mNGS increased the yield of virus detection by 77% (n = 23 virus hits). Specifically, mNGS identified 10 additional virus species beyond herpes- and enteroviruses. Of the additional 23 virus hits detected with mNGS, PCR confirmation was possible post hoc in 14 cases (61%). Linking digital case classification, mNGS, and PCR testing may not be feasible in routine care at this point but may help to provide hints to the pathogenesis of encephalitis/ADEM in childhood, warranting further research and exploration.

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Serum mir-142-3p release in children with viral encephalitis and its relationship with nerve injury and inflammatory response

Liu,

Wang,

Liu

et al. 2024

J. Neurovirol.

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Diagnosing viral encephalitis and emerging concepts

Cited by 7 publications

References 104 publications

Overview of reemerging mpox infection with a focus on neurological manifestations

Overview of reemerging mpox infection with a focus on neurological manifestations

Closing the Diagnostic Gap in Encephalitis and Acute Disseminated Encephalomyelitis through Digital Case Classification and Viral Metagenomics

Serum mir-142-3p release in children with viral encephalitis and its relationship with nerve injury and inflammatory response

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