Neurology of Acute Viral Infections

Krett, Jonathan D.; Beckham, J. David; Tyler, Kenneth L.; Piquet, Amanda L.; Chauhan, Lakshmi; Wallace, Carla; Pastula, Daniel M.; Kapadia, Ronak K.

doi:10.1177/19418744221104778

Cited by 5 publications

(9 citation statements)

References 92 publications

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“…Respiratory and/or gastrointestinal symptoms can precede enteroviruses-related encephalitis, parotitis implicates mumps, EBV can cause lymphadenopathy and/or splenomegaly, while upper respiratory tract symptoms are observed with respiratory viruses (including influenza, coronaviruses, and adenovirus) [32]. Dermatologic examination may reveal arthropod (or tick) bites suggesting arboviral infection, while grouped dermatomal vesicles suggest VZV [7].…”

Section: Physical Examinationmentioning

confidence: 99%

“…Pleocytosis with a white blood cell count less than 250 cells/ml, lymphocyte predominance, elevated protein (>50 mg/dl but usually less than 150 mg/dl), and normal glucose are suspicious for a viral cause. This contrasts CSF in an acute bacterial infection with higher white blood cells (>1000 cells/ ml, neutrophilic predominant), significantly elevated protein (>200 mg/dl), and hypoglycorrhachia [2, 7,33,34]. The highest yield for CSF viral nucleic acid is within the first week of symptoms [35].…”

Section: Cerebrospinal Fluidmentioning

confidence: 99%

“…The timeline for viral encephalitis typically begins sub-acutely (days to weeks) [7]; the notable exception being immunocompromised patients with indolent or chronic presentations [17]. An infectious prodrome can be observed, including fever, constitutional symptoms, headache, nausea/vomiting, fatigue/lethargy, myalgias, and/or rash.…”

Section: A Clinical Approach To the Patient With Suspected Viral Ence...mentioning

confidence: 99%

“…The highest yield for CSF viral nucleic acid is within the first week of symptoms [35]. CSF PCR for HSV has excellent sensitivity (98%) and specificity (94%) [7,35,36], although it is not sensitive if performed less than 72 h from symptom onset [1]. In practice, if the suspicion for HSV remains high despite an early negative result, strongly consider repeating the CSF PCR after 72 h [1].…”

Section: A Clinical Approach To the Patient With Suspected Viral Ence...mentioning

confidence: 99%

“…The global encephalitis incidence is 19.33 per 100 000 person-years [3 & ], with viral causes accounting for 20-50% of encephalitides [4][5][6]. Viruses can be categorized as sporadic, vaccine-preventable, geographically restricted, and those in the immunocompromised host; more than 40 viruses are implicated in encephalitis [7][8][9]10 && ,11 -13]. Herpes simplex virus (HSV) is the most common sporadic viral encephalitis with an annual incidence of 2-4 people per million worldwide [14]; 90% of cases are attributable to HSV-1 [15].…”

Section: Introductionmentioning

confidence: 99%

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Diagnosing viral encephalitis and emerging concepts

Yong

Pastula

Kapadia

2023

Current Opinion in Neurology

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Purpose of reviewThis review offers a contemporary clinical approach to the diagnosis of viral encephalitis and discusses recent advances in the field. The neurologic effects of coronaviruses, including COVID-19, as well as management of encephalitis are not covered in this review.Recent findingsThe diagnostic tools for evaluating patients with viral encephalitis are evolving quickly. Multiplex PCR panels are now in widespread use and allow for rapid pathogen detection and potentially reduce empiric antimicrobial exposure in certain patients, while metagenomic next-generation sequencing holds great promise in diagnosing challenging and rarer causes of viral encephalitis. We also review topical and emerging infections pertinent to neuroinfectious disease practice, including emerging arboviruses, monkeypox virus (mpox), and measles.SummaryAlthough etiological diagnosis remains challenging in viral encephalitis, recent advances may soon provide the clinician with additional tools. Environmental changes, host factors (such as ubiquitous use of immunosuppression), and societal trends (re-emergence of vaccine preventable diseases) are likely to change the landscape of neurologic infections that are considered and treated in clinical practice.

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Section: Physical Examinationmentioning

confidence: 99%

Section: Cerebrospinal Fluidmentioning

confidence: 99%

Section: A Clinical Approach To the Patient With Suspected Viral Ence...mentioning

confidence: 99%

Section: A Clinical Approach To the Patient With Suspected Viral Ence...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosing viral encephalitis and emerging concepts

Yong

Pastula

Kapadia

2023

Current Opinion in Neurology

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Evaluation of the Novel CE-IVD-Marked Multiplex PCR QIAstat-Dx Meningitis/Encephalitis Panel

et al. 2023

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The effectiveness of a synthetic analogue purine nucleoside bases in the treatment of acute respiratory viral infections

Kornova,

Karpov,

Lengina

et al. 2024

Medicinskij sovet

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Introduction. The aggravation of the comorbid background of patients with ARVI is the main reason for the addition of secondary pathogenic and conditionally pathogenic bacterial flora and, as a result, the development of local and general complications.Аim. To conduct a clinical assessment of the efficacy and safety of the drug Triazavirin based on riamilovir in the treatment of acute respiratory viral infections.Materials and methods. The study conducted on the basis of the medical center of the Federal State Budgetary Educational Institution of the Russian Ministry of Health involved 56 patients with acute recurrent viral infection. Regarding the prescribed therapy, the patients were divided into 2 groups: group 1 (n = 27) from day 2, triazavirin was taken as an antiviral drug (riamilo- vir) 250 mg (1 capsule) 3 times a day for 5 days; group 2 (n = 29) – as an antiviral drug, Kagocel took 2 tablets 3 times a day for 2 days, then 1 tablet 3 times a day for 5 days. The effect of the therapy was assessed by the severity of intoxication syndrome, rhinorrhea, difficulty in nasal breathing, decreased olfactory function, pain syndrome localized in the nasopharynx and throat, cough severity and laboratory results.Results. In patients with 7 days of therapy, the indicator of psychological health increased by 34.7 points in the first group, by 28.8 points in the second group. Vital activity increased by 33.7 points in patients of group 1 and by 23.8 points in the second group. Physical activity tended to increase by 19.5 points and 6.0 points in the first and second groups, respectively.Conclusions. The analysis of changes in the severity of clinical symptoms affecting the quality of life of patients confirmed the effectiveness and safety of the drug Triazavirin.

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Neurology of Acute Viral Infections

Cited by 5 publications

References 92 publications

Diagnosing viral encephalitis and emerging concepts

Diagnosing viral encephalitis and emerging concepts

Evaluation of the Novel CE-IVD-Marked Multiplex PCR QIAstat-Dx Meningitis/Encephalitis Panel

The effectiveness of a synthetic analogue purine nucleoside bases in the treatment of acute respiratory viral infections

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