1/16. Fatal encephalitis/encephalopathy in primary human herpesvirus-6 infection.An encephalitic illness with a fatal outcome occurred in a 9 month old girl with virologically confirmed exanthem subitum. Human herpes-virus-6 (HHV-6) dna was found in the cerebrospinal fluid at the acute stage of the disease by the polymerase chain reaction, but the virus antigen was not detected in her brain tissue. This suggests that HHV-6-induced encephalitis/encephalopathy may be due to a non-infectious process.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
2/16. Infection with human herpesvirus 6 after kidney-pancreas transplant.We describe the first known case of symptomatic infection resulting from human herpesvirus-6 (HHV-6) in simultaneous pancreas-kidney transplant recipients. The role of HHV-6 in solid-organ transplant recipients is not well defined. In hematopoietic stem cell transplantation (SCT) HHV-6 may cause fever, rash, myelosuppression, interstitial pneumonitis, and encephalitis.- - - - - - - - - - ranking = 1.25keywords = herpesvirus (Clic here for more details about this article) |
3/16. encephalitis owing to human herpesvirus-6 after cardiac transplant.Human herpesvirus-6 (HHV-6), a beta herpesvirus closely related to cytomegalovirus (CMV), infects the majority of the population in childhood. Human herpesvirus-6 can be reactivated in the immunosuppressed patient. After bone marrow and orthotopic liver transplant, it has been linked to various clinical syndromes, including undifferentiated febrile illness, encephalitis, pneumonitis and bone marrow suppression. To date its infectious role after orthotopic heart transplant has not been well documented. We present the case of a 32-year-old cardiac transplant recipient who initially presented 8 weeks after his transplant with high fever and headache. He developed increasing confusion, pulmonary infiltrates and neutropenia. cytomegalovirus viral loads were negative. polymerase chain reaction (PCR) of blood and cerebrospinal fluid detected HHV-6 dna, consistent with HHV-6-related encephalitis, pneumonitis and bone marrow suppression. He was treated with foscarnet with gradual improvement in clinical status. We review the literature on the significance of this virus post cardiac transplant.- - - - - - - - - - ranking = 1.75keywords = herpesvirus (Clic here for more details about this article) |
4/16. Human herpesvirus-6 hepatitis associated with cyclosporine-A encephalitis after bone marrow transplantation for chronic myeloid leukemia.A 31-year-old man referred to our hospital for treatment of his chronic myeloid leukemia (CML) in the first chronic phase by bone marrow transplantation. We pretreated him with cyclophosphamide and total body irradiation and bone marrow transplantation (BMT) was carried out. On day 31, the engraftment was confirmed and on day 52, acute graft versus host disease (GVHD) was observed. On day 189, he lost consciousness due to cyclosporine A-induced leukoencephalopathy and 375 mg cyclosporine A was changed to 100 mg prednisolone. On day 199, liver dysfunction (AST 410 IU/L, ALT 557 IU/L, gammaGTP 385 IU/L, ALP 363 IU/L, D-Bil 0.3 mg/dl) developed and a liver biopsy was performed. PCR analysis of dna from the liver biopsy specimen was positive for HHV-6 and immunostaining using anti-HHV-6 and anti-HHV-6b antibodies showed positive staining in the cytosol of hepatocytes. No other viruses were found to induce hepatitis. From these results, he was diagnosed as having HHV-6 hepatitis and it was successfully treated with gancyclovir (GCV) administration.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
5/16. Herpesvirus hominis encephalitis and retinitis.A previously healthy 44-year-old man died three weeks after the simultaneous onset of encephalitis and retinitis. Fundus changes were bilateral and included papillitis, rapidly progressive central retinal vein obstruction, and massive exudative retinal detachment. A 16-fold rise in herpesvirus hominis antibodies occured between the 10th and 20th days of illness. At autopsy, the brain showed changes characteristic of herpetic encephalitis, and cultures of the brain yielded Herpesvirus hominis type I. intranuclear inclusion bodies typical of those produced by Herpesvirus were found by light microscopy in brain, optic nerves, retina, and choroid. Herpesvirus particles were found by electron microscopy in brain, optic nerve, and retina.- - - - - - - - - - ranking = 0.25keywords = herpesvirus (Clic here for more details about this article) |
6/16. vidarabine therapy for severe herpesvirus infections. An unusual syndrome of chronic varicella and transient immunologic deficiency.Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.- - - - - - - - - - ranking = 1.5keywords = herpesvirus (Clic here for more details about this article) |
7/16. Chronic progressive varicella-zoster virus encephalitis in an AIDS patient.A patient with AIDS developed chronic, progressive encephalitis. Pathologic changes indicated that the encephalitis was produced primarily by a human herpesvirus. Hybridization of radiolabeled rna probes transcribed from cloned dna fragments of varicella-zoster virus (VZV), herpes simplex virus, cytomegalovirus, and the human immunodeficiency virus to dna extracted from the patient's brain identified VZV as the causative agent. The results suggest that VZV should be considered in the differential diagnosis of chronic encephalitis of unknown etiology, particularly in immunosuppressed patients.- - - - - - - - - - ranking = 0.25keywords = herpesvirus (Clic here for more details about this article) |
8/16. brain biopsy in cases of neonatal herpes simplex encephalitis.Neonatal herpes simplex encephalitis (HSE) can represent a difficult diagnostic problem when it occurs without concomitant mucocutaneus lesions and usually requires brain biopsy for diagnosis. Asymptomatic for the initial 2 to 4 weeks of life, the three infants we describe with localized HSE came to medical attention only because they developed persistent seizures and other nonspecific symptoms. Lumbar spinal fluid obtained from these children at clinical presentation showed an encephalitic pattern. Radionuclide brain scans revealed focal uptake of isotope in a variety of cortical areas, and electroencephalograms (EEGs) demonstrated repetitive, high amplitude, polyphasic sharp waves arising from analogous regions. Computed tomography (CT) showed nonspecific ill-defined areas of low density or contrast enhancement that did not correlate well with radionuclide, EEG, or clinical findings in two neonates. No infant had predominant temporal lobe involvement. Because these data suggested a multifocal, encephalitic process, all three infants underwent brain biopsy. A widespread infiltration of leukocytes and macrophages was observed in each specimen, and abundant intranuclear inclusions were present. Electron microscopy revealed abundant herpesvirus particles, and herpes simplex virus (HSV) was subsequently isolated from each sample. From our observations and our review of the literature, we propose the following criteria as indications for brain biopsy: brain biopsy is warranted to rule out HSE when a neonate presents with seizures, cerebrospinal fluid mononuclear pleocytosis with a negative gram stain, and focal, cortical disease on EEG and radionuclide scan.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.25keywords = herpesvirus (Clic here for more details about this article) |
9/16. Recovery of herpesviruses from cerebrospinal fluid of immunodeficient homosexual men.Over a one-year period the cerebrospinal fluid (CSF) obtained from a series of homosexual men immunocompromised with either Hodgkin's disease or acquired immune deficiency syndrome (AIDS) was cultured to assess the frequency with which infectious viruses could be recovered. Of 58 patients examined, 4 (6.9%) had CSF cultures that showed a cytopathology consistent with a virus infection. All isolates proved to be herpesviruses. cytomegalovirus (CMV) and varicella-zoster virus were isolated from CSF obtained from 2 patients with neurological features consistent with a subacute encephalitis common among AIDS patients. CMV was also recovered from the CSF of an AIDS patient who developed an ascending myelitis of herpesvirus origin. Finally, a CSF sample obtained from an immunodeficient homosexual man who showed no detectable neurological abnormalities consistently yielded herpes simplex virus type 1 in culture. These results suggest that seeding of the CSF with infectious virus is an uncommon event in this patient population. However, our experience should not dissuade attempts to culture viruses from CSF in similar cases. Successful isolations may prove beneficial in the diagnosis of an accompanying neurological illness and facilitate treatment with antiviral therapy when indicated.- - - - - - - - - - ranking = 1.5keywords = herpesvirus (Clic here for more details about this article) |
10/16. Varicella-zoster virus leukoencephalitis and cerebral vasculopathy.Two patients with varicella-zoster virus leukoencephalitis and acquired immunodeficiency syndrome are described. Neither patient had cutaneous or disseminated varicella-zoster virus infection within the last six months of life. Demyelinated lesions resembling those of progressive multifocal leukoencephalopathy were seen in their brains at autopsy. Numerous cells with Cowdry type A intranuclear inclusions surrounded the lesions; these cells stained positively for varicella-zoster virus with immunohistochemistry and contained herpesvirus nucleocapsids by electron microscopy. Leptomeningeal vessels accompanying the lesions displayed a zoster-induced vasculopathy in one of the two patients. Vascular and parenchymal central nervous system infections with varicella-zoster virus are rare in the absence of cutaneous lesions, and to our knowledge, the presence of both in one patient has not yet been described.- - - - - - - - - - ranking = 0.25keywords = herpesvirus (Clic here for more details about this article) |
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