Viral encephalitis

Silva, Marcus Tulius T.

doi:10.1590/0004-282x20130155

Cited by 36 publications

(88 citation statements)

References 26 publications

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“…Altered consciousness or altered behavior, followed by seizure and headache, has been reported to be the most common form of presentation in cases of acute encephalitis (2,3,10,11). Correspondingly, the most common form of presentation was altered behavior in two-thirds of the patients in our study, followed in decreasing order by headache, seizures, and loss of strength, while the most common neurological examination finding was isolated altered consciousness, observed in about two-thirds of our cases.…”

Section: Discussionsupporting

confidence: 60%

“…Laboratory findings of encephalitis are characterized with pleocytosis and elevated protein levels (1,2,3,6), with the exception of around 3 to 5 percent of patients with normal CSF analysis despite severe encephalitis, particularly initially (1,2). In our study, CSF pleocytosis was determined in 80.1% of patients, while protein levels were elevated in 57.4% of patients.…”

Section: Discussionmentioning

confidence: 99%

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Review of Viral Encephalitis Cases Seen at a Tertiary Care Center in Turkey: Focus on Herpes Simplex Type 1

Kavaklioglu¹,

Çoban²,

Şen³

et al. 2017

Arch Neuropsychiatr

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Introduction: The objective of this study was to determine the incidence of herpes simplex encephalitis (HSE), known as the most common, potentially mortal, and treatable cause of sporadic encephalitis, in a sample Turkish population. Methods:The demographic, clinical, laboratory, imaging, electrophysiology, and polymerase chain reaction (PCR) DNA results of patients examined with a pre-diagnosis of encephalitis were retrospectively examined.Results: A total of 68 patients were included in the study. The most common presenting symptom was altered behavior (67.6%), while temporal T2 hyperintensity was determined in the magnetic resonance imaging (MRI) of 27.9% of the patients and electroencephalography (EEG) abnormalities were determined in 66.2% of the patients. Lymphocytic pleocytosis was determined in the cerebrospinal fluid (CSF) in 35 patients. Fifty-seven patients had been diagnosed with viral encephalitis, 3 with bacterial meningitis, 3 with tuberculous meningitis, 2 with sporadic Creutzfeld-Jakob disease, 2 with acute disseminating encephalomyelitis, and 1 with Brucella encephalitis. Seven (10.2%) cases of viral encephalitis were found to be positive for herpes simplex virus (HSV) DNA by PCR.Conclusion: Viral encephalitis is the most common cause of infectious encephalitis; however, other atypical causes should also be noted. Negative PCR results for HSV DNA should not exclude the need for antiviral therapy in patients with a strong pre-diagnosis of HSE because diagnostic modalities, including PCR, may fail in acute settings and HSE remains the sole treatable cause of infectious encephalitis.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Review of Viral Encephalitis Cases Seen at a Tertiary Care Center in Turkey: Focus on Herpes Simplex Type 1

Kavaklioglu¹,

Çoban²,

Şen³

et al. 2017

Arch Neuropsychiatr

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“…4 Remarkably, even with the latest diagnostic technology, an agent is not identified in 70% of VE cases. 5 In the United States, about 2,000 cases occur annually and it is estimated that 90% of cases are caused by herpes simplex virus 1 (HSV-1) and 10% by HSV-2. 6,7 In a California study, only 16% of VE cases had probable etiologic agents identified, and HSV-1 was the most commonly detected agent in adult patients.…”

Section: Introductionmentioning

confidence: 99%

Seasonality of Viral Encephalitis and Associated Environmental Risk Factors in Son La and Thai Binh Provinces in Vietnam from 2004 to 2013

Lee¹,

Nguyen-Viet²,

Lee³

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. In Vietnam, Japanese encephalitis virus accounts for 12-71% of viral encephalitis (VE) cases followed by enteroviruses and dengue virus among identified pathogens. This study is the first attempt to evaluate the seasonality of VE and associated environmental risk factors in two provinces from 2004 to 2013 using a seasonal trend-decomposition procedure based on loess regression and negative binomial regression models. We found seasonality with a peak of VE in August and June in Son La and Thai Binh, respectively. In Son La, the model showed that for every 1°C increase in average monthly temperature, there was a 4.0% increase in monthly VE incidence. There was a gradual decline in incidence rates as the relative humidity rose to its mean value (80%) and a dramatic rise in incidence rate as the relative humidity rose past 80%. Another model found that a 100 mm rise in precipitation in the preceding and same months corresponded to an increase in VE incidence of 23% and 21%, respectively. In Thai Binh, our model showed that a 1°C increase in temperature corresponded with a 9% increase in VE incidence. Another model found that VE incidence increased as monthly precipitation rose to its mean value of 130 mm but declined gradually as precipitation levels rose beyond that. The last model showed that a monthly increase in duration of sunshine of 1 hour corresponded to a 0.6% increase in VE incidence. The findings may assist clinicians by improving the evidence for diagnosis.

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“…Some studies have shown that CMV infection occurs in critically sick patients who are admitted to ICUs and the prevalence ranges from 0 to 35 %. It can worsen the prognosis, prolong the ICU stay, extend ventilator use, and increase nosocomial infection [1, 4, 5, 10, 11]. …”

Section: Discussionmentioning

confidence: 99%

“…Ventriculoencephalitis is a CMV infection with brain stem involvement characterized by severe cranial nerves dysfunction and can lead to brain stem death (BSD) [5, 6]. Lung involvement can manifest as pneumonia or interstitial pneumonitis [7].…”

Section: Introductionmentioning

confidence: 99%

Recovery from a possible cytomegalovirus meningoencephalitis-induced apparent brain stem death in an immunocompetent man: a case report

2016

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BackgroundRecovery from cytomegalovirus meningoencephalitis with brain stem death in an immunocompetent patient is almost impossible. We present a remarkable recovery from a possible cytomegalovirus infection in an immunocompetent man who had severe neurological syndromes, suggesting brain stem death complicated by pneumonia and pleural effusion.Case presentationA 19-year-old Asian man presented at our hospital’s emergency department with reduced consciousness and seizures following high fever, headache, confusion, and vomitus within a week before arrival. He was intubated and sent to our intensive care unit. He had nuchal rigidity and tetraparesis with accentuated tendon reflexes. Electroencephalography findings suggested an acute structural lesion at his right temporal area or an epileptic state. A cerebral spinal fluid examination suggested viral infection. A computed tomography scan was normal at the early stage of disease. Immunoglobulin M, immunoglobulin G anti-herpes simplex virus, and immunoglobulin M anti-cytomegalovirus were negative. However, immunoglobulin G anti-cytomegalovirus was positive, which supported a diagnosis of cytomegalovirus meningoencephalitis. His clinical condition deteriorated, spontaneous respiration disappeared, cranial reflexes became negative, and brain stem death was suspected. Therapy included antivirals, corticosteroids, antibiotics, anticonvulsant, antipyretics, antifungal agents, and a vasopressor to maintain hemodynamic stability. After 1 month, he showed a vague response to painful stimuli at his supraorbital nerve and respiration started to appear the following week. After pneumonia and pleural effusion were resolved, he was weaned from the ventilator and moved from the intensive care unit on day 90.ConclusionsThis case highlights several important issues that should be considered. First, the diagnosis of brain stem death must be confirmed with caution even if there are negative results of brain stem death test for a long period. Second, cytomegalovirus meningoencephalitis should be considered in the differential diagnosis even for an immunocompetent adult. Third, accurate therapy and simultaneous intensive care have very important roles in the recovery process of patients with cytomegalovirus meningoencephalitis.

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Viral encephalitis

Cited by 36 publications

References 26 publications

Review of Viral Encephalitis Cases Seen at a Tertiary Care Center in Turkey: Focus on Herpes Simplex Type 1

Review of Viral Encephalitis Cases Seen at a Tertiary Care Center in Turkey: Focus on Herpes Simplex Type 1

Seasonality of Viral Encephalitis and Associated Environmental Risk Factors in Son La and Thai Binh Provinces in Vietnam from 2004 to 2013

Recovery from a possible cytomegalovirus meningoencephalitis-induced apparent brain stem death in an immunocompetent man: a case report

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