Herpes simplex encephalitis in patients receiving chemotherapy and whole-brain radiation therapy

Hersh, Nir; Steiner, Israel; Siegal, Tali; Benninger, Felix

doi:10.1007/s13365-021-01018-3

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…For example, in a case series of HSV encephalitis among seven cancer patients, CSF white blood cell (WBC) count was normal in four [ 16 ]. Others have reported similar findings of normal CSF WBC count among cancer patients when HSV-1 encephalitis was confirmed by PCR testing of the CSF [ 37 ]. While chemotherapy or corticosteroids may be the contributing factors for HSV reactivation and disease progression in cancer patients, those receiving whole-brain radiation therapy (WBRT) might be particularly at risk.…”

Section: Pathogenesis and Clinical Manifestationsmentioning

confidence: 55%

“…HSV encephalitis has been reported in cancer patients shortly after WBRT [ 16 ]. In a recent review of 28 cases of HSV encephalitis in patients receiving chemotherapy and WBRT, seven had onset during radiation therapy, additional nine had onset within two weeks and another had onset within one month after radiation therapy [ 37 ]. Patients receiving certain immunomodulatory therapies or biologics may also be at increased risk for HSV encephalitis [ 38 ].…”

Section: Pathogenesis and Clinical Manifestationsmentioning

confidence: 99%

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Herpes Simplex Virus and Varicella Zoster Virus Infections in Cancer Patients

Tayyar

2023

Viruses

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Herpes simplex virus (HSV) and varicella zoster virus (VZV) are alpha herpesviruses that establish life-long latent infection in neuronal ganglia after primary infection. Periodic reactivation of these viruses results in recurrent infections that can have significant impact on patients’ quality of life. HSV commonly causes oral and genital mucocutaneous infections whereas VZV is responsible for varicella/chickenpox and herpes zoster/shingles, but cancer patients are at particularly higher risk of complications including disseminated and visceral infections due to impaired cell-mediated immunity. While diagnosis of more common HSV and/or VZV infections is frequently clinically based, immunocompromised hosts may have atypical skin presentation or visceral involvement. Thus, diagnostic confirmation using virus-specific tests such as polymerase chain reaction or immunohistochemical staining is crucial in some cases. Oral acyclovir, valacyclovir and famciclovir are usually used for mild to moderate infections and intravenous acyclovir is the drug of choice for severe or disseminated infections. Foscarnet can be used when acyclovir-resistance is confirmed or suspected. Pharmaceutical prophylaxis against HSV and/or VZV should be considered in high-risk cancers patients. Currently, there is no commercially available vaccine against HSV, but VZV vaccines are available to prevent varicella and zoster.

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Section: Pathogenesis and Clinical Manifestationsmentioning

confidence: 55%

Section: Pathogenesis and Clinical Manifestationsmentioning

confidence: 99%

Herpes Simplex Virus and Varicella Zoster Virus Infections in Cancer Patients

Tayyar

2023

Viruses

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“…HSV has clinically been detected to induce neurological complications in infected patients. For instance, encephalitis is the most acute neurological complication of CNS triggered by HSV-1 infection with symptoms including headache, fever, lethargy, confusion, irritability, aphasia, seizures, and focal deficit [ 77 ]. In a clinical study that has recently been published by Ordoñez et al [ 78 ], HSV-1 was observed to contribute to the complex mechanisms of autoimmunity of Bell’s palsy, the most common acute neuropathy of cranial nerves.…”

Section: Flavonoids Target Human Herpesviruses Of the Nervous Systemmentioning

confidence: 99%

Flavonoids Target Human Herpesviruses That Infect the Nervous System: Mechanisms of Action and Therapeutic Insights

Šudomová¹,

Berchová‐Bímová

Mazuráková

et al. 2022

Viruses

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Human herpesviruses (HHVs) are large DNA viruses with highly infectious characteristics. HHVs can induce lytic and latent infections in their host, and most of these viruses are neurotropic, with the capacity to generate severe and chronic neurological diseases of the peripheral nervous system (PNS) and central nervous system (CNS). Treatment of HHV infections based on strategies that include natural products-derived drugs is one of the most rapidly developing fields of modern medicine. Therefore, in this paper, we lend insights into the recent advances that have been achieved during the past five years in utilizing flavonoids as promising natural drugs for the treatment of HHVs infections of the nervous system such as alpha-herpesviruses (herpes simplex virus type 1, type 2, and varicella-zoster virus), beta-herpesviruses (human cytomegalovirus), and gamma-herpesviruses (Epstein–Barr virus and Kaposi sarcoma-associated herpesvirus). The neurological complications associated with infections induced by the reviewed herpesviruses are emphasized. Additionally, this work covers all possible mechanisms and pathways by which flavonoids induce promising therapeutic actions against the above-mentioned herpesviruses.

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