Cases reported "Acute Disease"

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1/17. PCR in meningoencephalitis diagnosis.

    polymerase chain reaction (PCR) detection of a stretch of nucleic acid sequence of microbial origin from a clinical sample is not always diagnostic of disease unless the identified agent is a strict pathogen or its growth is documented. We describe here a case of acute meningoencephalitis in a 21-y-old man, in whom no pathogen was isolated by traditional bacterial or viral culture. Standard dna PCR performed on the cerebrospinal fluid (CSF) identified the presence of 3 infectious agents: HHV-6, HHV-7 and mycoplasma pneumoniae. Additional PCRs performed on CSF fractions along with gene transcript analysis proved the bystander role of the 2 herpesviruses and indicated M. pneumoniae as the relevant replicating agent, most likely playing to be a pathogenic role. Until this useful analysis becomes routine, clinicians should deal carefully with dna PCR results, especially when assessing the aetiological role of agents, such as herpesviruses, which are known to undergo latency.
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ranking = 1
keywords = herpesvirus
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2/17. Chronic graft-versus-host disease after hematopoietic cell transplantation presenting as an acute hepatitis.

    A variety of illnesses involving the gut and liver follow hematopoietic cell transplantation (HCT). A 20 yr-old white male developed severe acute hepatitis 36 wk (day 252) after matched, unrelated, allogeneic HCT for chronic myelogenous leukemia (CML). Mild skin graft-versus-host disease (GVHD) had occurred at about 20 wk (day 140) after transplant. Liver biopsy showed bile duct injury and a diffuse lobular injury pattern most consistent with a GVHD variant and not reminiscent of drug-induced or viral hepatitis. No findings suggestive of herpesvirus, adenovirus, or varicella-zoster virus were found. High-dose steroids resulted in marked improvement of his liver enzyme levels. We report this patient as representing the acute hepatitic presentation of chronic GVHD of the liver.
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ranking = 0.5
keywords = herpesvirus
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3/17. Acute liver failure in pregnancy. A case report.

    BACKGROUND: Liver disease in pregnancy can be grossly divided into those disorders coincidentally occurring during the pregnant state and hepatic diseases limited to pregnancy. Numerous infectious agents can result in acute hepatitis and include not only the hepatitis viruses--A, B, C and E--but herpesvirus and cytomegalovirus as well. Coxsackie B viruses can cause several clinical presentations, ranging from asymptomatic to mild febrile illness to myocarditis and meningitis. Rarely has coxsackievirus infection been associated with fulminant hepatic failure. CASE: A Coxsackie B virus infection resulted in acute liver failure in a gravid woman. The patient was managed expectantly, with resolution of the liver disease and delivery five weeks after discharge. CONCLUSION: The onset of hepatic disease is insidious, with only vague symptoms or minor complaints often heralding the progression to liver failure. A careful history, physical examination and appropriate diagnostic tests can help determine the etiology of hepatic disease and help decide whether expectant management of the gravid patient or immediate delivery is appropriate.
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ranking = 0.5
keywords = herpesvirus
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4/17. Fatal acute myocarditis in an infant with human herpesvirus 6 infection.

    A 5 month old girl had typical clinical features of acute myocarditis just after the febrile period of exanthem subitum and died immediately. She had been healthy, with normal development, and there was no family history of particular note. Myocardial postmortem findings were compatible with acute myocarditis. Although the isolation of human herpesvirus 6 (HHV-6) was not attempted, positive IgM antibody to HHV-6 was detected in the patient's serum. Moreover, HHV-6 variant B dna was detected in several tissues, including myocardium, by the polymerase chain reaction (PCR). In contrast, antibody responses to human herpesvirus 7, another causal agent of exanthem subitum, were not found, and enteroviral rna was not detected in myocardial tissues by reverse transcription PCR. Apoptotic changes were seen in infiltrating cells within the myocardial tissues by means of the TUNEL method. HHV-6 antigen was not detected in several tissues (including myocardium) by immunohistochemical analysis. In conclusion, HHV-6 may have been the causative agent of fatal acute myocarditis in this infant.
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ranking = 3
keywords = herpesvirus
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5/17. Fatal myocarditis associated with acute parvovirus B19 and human herpesvirus 6 coinfection.

    We report on the case of a healthy young boy who developed a fulminant myocarditis due to acute coinfection with erythrovirus (parvovirus B19) and human herpesvirus 6 (HHV-6) in the absence of an antiviral immune response. We suggest that the HHV-6-induced immunosuppression enhanced dissemination of parvovirus B19, which led to fatal myocarditis.
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ranking = 2.5
keywords = herpesvirus
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6/17. Cranial polyneuritis and bell palsy.

    In view of the specific nature of the clinical and neurologic findings in bell palsy and other acute benign cranial neuritides, the neural component of cutaneous herpes simplex, the predilection of the herpesvirus for sensory nerves, and intrinsic behavior and immunologic interreactions of the herpesvirus within ganglion cells, it is suggested that (1) the entity that has been termed "idiopathic facial paralysis" be recognized as an acute benign cranial polyneuritis; and (2) other acute benign cranial neuritides be recognized as formes frustes of bell palsy.
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ranking = 1
keywords = herpesvirus
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7/17. Activation of human herpesvirus-6 in children with acute measles.

    Virological and serological studies were carried out prospectively to evaluate the possible activation of human herpesvirus-6 (HHV-6) in 50 infants and children with acute measles by isolation of HHV-6 from peripheral blood and by determining neutralizing antibodies to the virus. All but 5 patients (90%) were seropositive to HHV-6 in the acute stage of measles and 18 (40%) had a significant increase in HHV-6 antibody titers thereafter, whereas only 2 of 27 patients who were initially seropositive to Epstein-Barr virus (EBV) viral capsid antigen (VCA) had a significant rise in antibody titers to EBV VCA. Among 18 patients with a significant increase in HHV-6 titers, the virus was isolated from the peripheral blood mononuclear cells of three patients in the early convalescent stage of measles. These results indicate that activation of HHV-6 may occur frequently a few weeks after primary infection with the measles virus.
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ranking = 2.5
keywords = herpesvirus
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8/17. Acute respiratory failure and cerebral hemorrhage due to primary Epstein-Barr virus infection.

    Epstein-Barr virus (EBV) is a ubiquitous human herpesvirus with worldwide distribution. Primary infection with EBV occurs early in life and typically presents as infectious mononucleosis. The usual course of the disease is benign and most patients recover uneventfully. Severe infections are reported particularly in immunocompromised patients. Mild, asymptomatic pneumonitis is reported in about 5-10% of cases of infectious mononucleosis, but severe pneumonitis with hypoxemia is very rare in immunocompetent individuals. We report a young female adolescent in whom an acute EBV infection led to severe bilateral pneumonitis, a systemic inflammatory response and intracerebral bleeding. The clinical course and results of quantitative viral dna determinations in plasma are presented.
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ranking = 0.5
keywords = herpesvirus
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9/17. Acute ocular infection by type 2 herpes simplex virus in adults.

    Acute ocular infections in two adults were caused by type 2 herpes simplex virus (HSV) ("genital herpesvirus"). One patient had an acute blepharoconjunctivitis, the other an acute keratoconjunctivitis. Genital infections had preceded the eye infections, and type 2 HSV was isolated from the eyes of both patients and from the genital lesions of one patient. This strongly suggests transmission of type 2 HSV from the genital site to the eye.
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ranking = 0.5
keywords = herpesvirus
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10/17. Immune complex containing herpesvirus antigen in a patient with acute retinal necrosis.

    A 21-year-old man with acute retinal necrosis showed a marked increase in the convalescent titer to herpes simplex type 1 virus, especially in the aqueous humor obtained by anterior chamber paracentesis. Using an enzyme-linked immunosorbent assay, we tried to detect the herpesvirus antigen in the circulating immune complex obtained from this patient. The immune complex contained an antigen or antigens that reacted with antiherpes simplex type 1 antibody.
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ranking = 2.5
keywords = herpesvirus
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