Epidemiology of infectious encephalitis causes in 2016

Boucher, Alexander A.; Herrmann, Jean-Louis; Morand, Patrice; Buzelé, Rodolphe; Crabol, Yoann; Stahl, J.-P.; Mailles, Alexandra

doi:10.1016/j.medmal.2017.02.003

Cited by 140 publications

(136 citation statements)

References 71 publications

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“…Surprisingly, the metagenomics results showed that the infectious etiology was actually HSV-1. Although HSV-1 is a frequent cause of encephalitis, especially in immunocompromised patients [22], in-hospital HSV-1 encephalitis is very rare except for patients with certain known risk factors such as neurological surgeries or the use of anti-inflammatory drugs [23]. Our patient was immunocompetent, did not have any recent surgery, and was not given anti-inflammatory treatment.…”

Section: Discussionmentioning

confidence: 99%

Real-time Utilization of Metagenomic Sequencing in the Diagnosis and Treatment Monitoring of an Invasive Adenovirus B55 Infection and Subsequent Herpes Simplex Virus Encephalitis in an Immunocompetent Young Adult

Fang

et al. 2018

Open Forum Infectious Diseases

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BackgroundMetagenomic sequencing has shown tremendous promise in solving difficult infectious diseases cases. In this study, we utilized this technology to help guide the care of a critically ill patient with severe pneumonia, fever of unknown origin, and subsequent encephalitis in the intensive care unit (ICU).MethodsShotgun metagenomic sequencing was performed on the patient’s blood, bronchoalveolar lavage (BAL), and cerebral spinal fluid by using an Illumina MiniSeq sequencer.Results. A high load of human adenovirus B55 (HAdV-B55), a highly pathogenic adenovirus associated with numerous recently reported outbreaks and deaths in China, was detected in both blood and BAL, which explained the severity of the condition. The patient was treated with intravenous ribavirin, which cleared the virus after 26 days. Metagenomic sequencing also helped diagnose an unexpected herpes simplex virus–1 encephalitis during hospitalization, which led to timely treatment.Conclusions. This was the first successful case utilizing metagenomic sequencing to guide diagnosis and treatment in the ICU setting in China. We have proven the concept that metagenomic sequencing can play an important role in determining clinical approaches and ultimately in improving patient outcomes. We also hope to share our successful treatment protocol for the severe pneumonia and viremia caused by HAdV-B55.

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Section: Discussionmentioning

confidence: 99%

Real-time Utilization of Metagenomic Sequencing in the Diagnosis and Treatment Monitoring of an Invasive Adenovirus B55 Infection and Subsequent Herpes Simplex Virus Encephalitis in an Immunocompetent Young Adult

Fang

et al. 2018

Open Forum Infectious Diseases

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“…In cases where a causative agent of infection is not identified, metagenomic analyses can be used to rapidly identify potential pathogens . For example, hundreds of pathogens have been associated with infectious encephalitis, and in as many as 60% of encephalitis cases, conventional laboratory assays fail to detect a causative agent . Accurate and rapid identification of the infectious agent is critical as the main alternative diagnosis is immune‐mediated encephalitis, which requires immune suppression for treatment .…”

Section: Using Metagenomics To Improve Identification Of Aros and CLImentioning

confidence: 99%

“…37 Accurate and rapid identification of the infectious agent is critical as the main alternative diagnosis is immune-mediated encephalitis, which requires immune suppression for treatment. 37 In one striking case, an HIV-infected patient was admitted to a hospital with lethally diffuse brain lesions. 25 The patient's blood and cerebrospinal fluid tests were negative for common microbial infections.…”

Section: Using Metagenomics To Improve Identification Of Aros and CLImentioning

confidence: 99%

Genomic and Metagenomic Approaches for Predictive Surveillance of Emerging Pathogens and Antibiotic Resistance

Sukhum

Diorio-Toth

Dantas

2019

Clin Pharma and Therapeutics

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Antibiotic‐resistant organisms (AROs) are a major concern to public health worldwide. While antibiotics have been naturally produced by environmental bacteria for millions of years, modern widespread use of antibiotics has enriched resistance mechanisms in human‐impacted bacterial environments. Antibiotic resistance genes (ARGs) continue to emerge and spread rapidly. To combat the global threat of antibiotic resistance, researchers must develop methods to rapidly characterize AROs and ARGs, monitor their spread across space and time, and identify novel ARGs and resistance pathways. We review how high‐throughput sequencing‐based methods can be combined with classic culture‐based assays to characterize, monitor, and track AROs and ARGs. Then, we evaluate genomic and metagenomic methods for identifying ARGs and biosynthetic pathways for novel antibiotics from genomic data sets. Together, these genomic analyses can improve surveillance and prediction of emerging resistance threats and accelerate the development of new antibiotic therapies to combat resistance.

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“…The Californian encephalitis project reported that HSV was responsible for 24% of identified cases of encephalitis from 1998 to 2001 [3] . Worldwide, a recent literature review [4] observed that HSV was reported to be the most frequent agent in 65% of studies. Varicella-zoster virus was the second most frequent agent.…”

Section: Epidemiology and Burdenmentioning

confidence: 99%

Herpes Simplex Virus Encephalitis: An Update

Stahl¹,

Mailles²

2019

mjima

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Herpes simpleks virüsü (HSV) erişkinlerde sporadik enfektif ensefalitin en sık nedenidir. Antiviral tedavilere rağmen, olgu fatalite oranı orta ila yüksek arasında değişen oranlarda (çalışma ve ülkelere göre %5 ila %30) değişmektedir. Tanı yöntemlerinin bir tarafında beyin omurilik sıvısında spesifik polimeraz zincir reaksiyonu testleri diğer tarafında manyetik rezonans görüntüleme yer almaktadır. Çeşitli ülkelerin tedavi rehberleri, günde üç kez sistemik 10 mg/kg asiklovir tedavisinin mikrobiyolojik doğrulama beklenmeden başlanmasını önermektedir. Diğer bir soru kortikosteroidlerin yararlı olup olmadığıdır. Bu soru geç dönem sekel sıklığı (hastaların %30-40'ı) ve yakın zamanda bildirilen HSV ile tetiklenen otoimmün ensefalit ile ilgilidir. Bu iki olası komplikasyonda, profilaktik tedavi olarak steroidler yararlı olabilir, ancak kesinlik kazanması için yapılacak spesifik klinik çalışmalara ihtiyaç vardır. Genetik özellikler yakın zamanda tanımlanmış ve bazı hastalardaki ensefalit oluşumunu açıklamıştır, ancak henüz tüm olguları açıklayamamaktadır. Anahtar Kelimeler: Asiklovir, herpes simpleks virüs, sekel, otoimmün ensefalit, gansiklovir ÖzHerpes simplex virus (HSV) is the most frequent cause of sporadic infective encephalitis in adults. Despite antiviral therapies, the case fatality rate is moderate to high (5 to 30% according studies and countries). Tools for diagnosis are specific polymerase chain reaction testing of the cerebrospinal fluid on one hand and magnetic resonance imaging on the other hand. Guidelines of various countries recommend systematic treatment by acyclovir 10 mg/kg, three times a day, starting before microbiological confirmation. The remaining question is the usefulness of corticosteroids. This question is related to the frequency of late sequalae (30 to 40% of patients) and the recent demonstration of auto-immune encephalitis triggered by HSV encephalitis. These two possible complications suggest the usefulness of steroids as prophylactic treatment but specific clinical trials are needed for confirmation. Genetic features were recently identified, explaining encephalitis occurrence in some patients, but do not explain all cases so far.

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Epidemiology of infectious encephalitis causes in 2016

Cited by 140 publications

References 71 publications

Real-time Utilization of Metagenomic Sequencing in the Diagnosis and Treatment Monitoring of an Invasive Adenovirus B55 Infection and Subsequent Herpes Simplex Virus Encephalitis in an Immunocompetent Young Adult

Real-time Utilization of Metagenomic Sequencing in the Diagnosis and Treatment Monitoring of an Invasive Adenovirus B55 Infection and Subsequent Herpes Simplex Virus Encephalitis in an Immunocompetent Young Adult

Genomic and Metagenomic Approaches for Predictive Surveillance of Emerging Pathogens and Antibiotic Resistance

Herpes Simplex Virus Encephalitis: An Update

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