Herpes encephalitis

Dudgeon, J. A.

doi:10.1136/pgmj.45.524.386

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…The results were highly consistent with many of the pathological changes that have been previously documented for this disorder (Damasio and Van Hoesen, 1985;Dinn, 1979;Dudgeon, 1969;Kennedy et al, 1988). However, it is important to point out that our findings do not demonstrate every possible area of involvement in HSE, and they illustrate possible areas of caution when applying this methodology to other disorders.…”

Section: Discussionsupporting

confidence: 89%

Voxel-Based Morphometry of Herpes Simplex Encephalitis

et al. 2001

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Voxel-based morphometry (VBM) is a powerful tool for analyzing changes in gray or white matter density of the brain. By using an automated segmentation procedure and standardized parametric statistics it avoids biases inherent in operator-dependent morphological operations (J. Ashburner and K. J. Friston, 2000, NeuroImage 11, 805-821). Since its introduction in 1995, VBM has been used to examine anatomical changes in a variety of diseases associated with neurologic and psychiatric dysfunction. Given the power of this technique for discerning subtle anatomical changes, we wanted to assess its performance on brains with gross structural abnormalities. Such results could have implications regarding the difficulties to be faced when examining other types of distorted brains (e.g., brains with changes due to degenerative disease). This report describes the use of VBM for examining individual and group changes in gray matter concentration in five patients who had recovered from herpes simplex encephalitis (HSE) compared with age-and sex-matched controls. Because HSE tends to affect a specific set of brain regions we thought that this would (1) provide an opportunity to assess the anatomical face validity of VBM, (2) allow us to assess the problems of this technique when used on distorted brains, and (3) provide an in vivo demonstration of the gray matter changes due to HSE. We found that, despite problems in normalizing and segmenting these severely distorted brains, VBM was able to identify correctly a number of the regional gray matter abnormalities in HSE. The results, while consistent with the well-known histopathology of the disease, also demonstrate potential difficulties with this method.

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Section: Discussionsupporting

confidence: 89%

Voxel-Based Morphometry of Herpes Simplex Encephalitis

et al. 2001

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“…Accordingly, in 2018 ( Broberg et al, 2018 ), the unusual persistence of mixed Enterovirus and Human parechovirus outbreaks infecting new-borns and children until the autumn correlated with a notable 2°C increase in autumn temperatures in October/November 2018 compared to seasonal norms ( Cabrerizo et al, 2015 ). Most intriguing was the observation that DNA viruses also adopted an outbreak pattern, with HSV-1 CAM being observed in elderly male patients in January–March, probably due to the HSV-1 reactivation ( Dudgeon, 1969 ; Taylor et al, 2002 ), which is potentially prompted by vitamin D deficiency related to low sun exposure in winter, especially in people >70 years old, as previously reported ( Lin et al, 2019 , 2020 ; Cristian Ilie and Stefanescu, 2020 ). Accordingly, significant correlations between pathogen, gender and age differentially observed in Nimes and Marseille may simply reflect differences in the population structure in these two different cities.…”

Section: Discussionmentioning

confidence: 53%

“…Accordingly, in 2018 (Broberg et al, 2018), the unusual persistence of mixed Enterovirus and Human parechovirus outbreaks infecting new-borns and children until the autumn correlated with a notable 2°C increase in autumn temperatures in October/November 2018 compared to seasonal norms (Cabrerizo et al, 2015). Most intriguing was the observation that DNA viruses also adopted an outbreak pattern, with HSV-1 CAM being observed in elderly male patients in January-March, probably due to the HSV-1 reactivation (Dudgeon, 1969;Taylor et al, 2002), which is potentially prompted by Multiple correspondence analysis (MCA) of the variables of seasons, outbreak number, identified pathogens gathered by microorganisms' groups (RNA virus, DNA virus, Bacteria, and Fungi), gender, and age. In summer, five outbreaks caused by RNA viruses infecting young patients (61%), represented 52.8% (p < 10 −4 ) of summer outbreaks.…”

Section: Discussionmentioning

confidence: 98%

Dynamics of community-acquired meningitis syndrome outbreaks in southern France

Morsli

Salipante²,

Kerharo³

et al. 2023

Front. Microbiol.

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In southern France, cases of community-acquired meningitis syndrome (CAM) are typically clustered as outbreaks with determinants which remain unknown. This 61-month retrospective investigation in Nîmes and Marseille university hospital laboratories, yielded 2,209/20,779 (10.63%) documented CAM cases caused by 62 different micro-organisms, represented by seasonal viral etiologies (78.8%), including Enterovirus, Herpes Simplex Virus (HSV), and Varicella-Zoster Virus (VZV; 1,620/2,209 = 73.4%). Multi correspondence analysis revealed an association of infection with age and sex, with the risk of infection being relatively higher in young men, as confirmed by Fisher’s exact test (p < 10−3). Bacterial meningitis accounted for 20% of cases, mostly caused by Streptococcus pneumoniae (27.4% of cases), Neisseria meningitidis (12.5%), and Haemophilus influenzae (9.5%) with bacteria/virus coinfection (0.9%), and only six cases of documented fungal meningitis. In total, 62.6% of cases, of which 88.7% were undocumented, arose from 10 outbreaks. 33.2% of undocumented cases were aged >60 years compared to 19.2% of documented cases (p < 0.001), and viral infection was more common in the summer (87.5%) compared to other seasons (72.3%; p < 0.001). Outbreaks most often started in Nîmes and moved eastward toward Marseille at a speed of ~9 km/day, and these dynamics significantly correlated with atmospheric temperature, especially during summer outbreaks. In particular, the incidence of Enterovirus-driven outbreaks correlated with temperature, revealing correlation coefficients of 0.64 in Nîmes and 0.72 in Marseille, and its occurrence in Marseille lagged that in Nîmes by 1–2 weeks. Tracing the dynamics of CAM outbreak during this retrospective investigation in southern France yielded a speed of displacement that correlated with the variation in temperature between both cities, and these results provide clues for the next occurrence of undocumented outbreaks.

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“…Herpetic encephalitis is marked by necrotic-hemorrhagic lesions, with perivascular lymphocytic infiltration in the necrotic tissues and the meninges [ 4 ]. These result in broad malacic areas as a result of tissue destruction and secondary atrophy [ 5 ]. Infected patients develop prodromal symptoms, such as malaise, fever, headache, and nausea, followed by the acute or subacute onset of neurological symptoms, which can include lethargy, confusion, and delirium.…”

Section: Discussionmentioning

confidence: 99%