1/18. west nile virus-associated encephalitis in recipients of renal and pancreas transplants: case series and literature review.Although west nile fever is mild in the vast majority of infected persons, there is growing evidence that the disease may be more severe in the immunocompromised population. We describe 3 recipients of kidney or pancreas transplants who developed west nile fever, 2 of whom had meningoencephalitis. As is the norm when treating serious infections in transplant recipients, a reduction of immunosuppression was pursued for these patients. Despite the severe nature of the disease in 2 patients, all recovered from the disease. The time course of neurologic recovery in the 2 patients with meningoencephalitis is highlighted. We also review the literature on west nile fever in organ transplant recipients. In areas where west nile virus is endemic, one must have a high index of suspicion for the illness when dealing with fever in transplant recipients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/18. Molecular diagnosis and typing of trypanosoma cruzi populations and lineages in cerebral chagas disease in a patient with AIDS.trypanosoma cruzi dna was amplified from an intracranial biopsy and peripheral blood of an hiv patient with encephalitis; this episode was indicative of AIDS and congenital chagas disease. The analysis of a micro-satellite locus revealed a multiclonal parasite population at the brain lesion with a more complex minicircle signature than that profiled in blood using restriction fragment length polymorphism (RFLP)-PCR and low stringency single primer (LSSP) PCR. Interestingly, different sublineages of T. cruzi II were detected in blood and brain by means of spliced-leader and 24salpha ribosomal-dna amplifications. Quantitative-competitive PCR monitored the decrease of parasitic load during treatment and secondary prophylaxis with benznidazole. The synergy between parasiticidal plus anti-retroviral treatments probably allowed the patient a longer survival than usually achieved in similar episodes. This is the first case report demonstrating a differential distribution of natural parasite populations and sublineages in chagas disease reactivation, showing the proliferation of cerebral variants not detectable in peripheral blood.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/18. The neurological complications of cardiac transplantation.review of the neurological complications encountered in 83 patients who received cardiac homografts over a seven-year period leads to the following conclusions: (1) Neurological disorders are common in transplant recipients, occurring in over 50 per cent of patients. (2) infection was the single most frequent cause of the neurological dysfunction, being responsible for one-third of all CNS complications. (3) The infective organisms were typically those considered to be usually of low pathogenicity: fungi, viruses, protozoa and an uncommon bacterial strain. (4) Other clinical neurological syndromes were related to vascular lesions, often apparently from cerebral ischaemia or infarction occurring during the surgical procedure, metabolic encephalopathies, cerebral microglioma, acute psychotic episodes and back pain from vertebral compression fractures. (5) The infectious complications and probably the development of neoplasms de novo, are related to immunosuppressive therapy which impairs virtually all host defence mechanisms and alters the nature of the host's response to infective agents or other foreign antigens. (6) Because neurological symptoms and signs were usually those of behavioural changes or deterioration in intellectual performance, the neurological examination was often of little value in diagnosing the nature or even the anatomical site of the neuropathological process. (7) The possibility of an infectious origin of the neurological manifestations must be aggressively pursued even in the absence of fever and a significantly abnormal spinal fluid examination. The diagnostic error made most frequently was to ascribe neurological symptoms erroneously to metabolic disturbances or to "intensive care unit psychosis" when they were in fact due to unrecognized CNS infection. (8) maintenance of mean cardiopulmonary bypass pressures above 70 mmHg, particularly in patients with known arteriosclerosis, may reduce operative morbidity. (9) Though increased diagnostic accuracy is possible with routine use of a variety of radiological and laboratory techniques, two further requirements probably must be met before a significant reduction in the frequency of neurological complications will occur: the advent of greater immunospecificity in suppressing rejection of the grafted organ while preserving defences against infection; and a more effective armamentarium of antiviral and antifungal drugs.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
4/18. coma as a presenting sign of Epstein-Barr encephalitis.Among the many different manifestations of Epstein-Barr virus (EBV) infection, neurologic disturbances are less frequently observed, and they are diverse in nature. A young woman was admitted with acute hyperthermia, mydriasis, nystagmus, respiratory insufficiency, muscular hypertonia, evolving to decerebrate posturing, and bilateral facial epileptic contractions. The appearance of atypical blood lymphocytes, hepatitis, migrating skin rash, positive heterophile antibody tests, and specific serologic tests for EBV led to a diagnosis of EBV encephalitis. Under treatment with intravenously administered acyclovir, the patient recuperated almost completely. This case illustrates a less frequent manifestation of EBV infection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/18. prosopagnosia and object agnosia without covert recognition.Investigations of the visual recognition abilities of the patient M.S. are reported. M.S. is unable to achieve overt recognition of any familiar faces, and many everyday objects. In Task 1 he showed semantic priming from name primes but not from face primes in a name recognition task. In Task 2 he showed no advantage in learning true (face correct name) rather than untrue (face someone else's name) pairings of faces and names. In Task 3 semantic priming of lexical decision was only found for object picture primes that M.S. was able to recognize overtly. In Task 4 faster matching of photographs of familiar than unfamiliar objects was only found for objects that M.S. was able to recognize overtly. These findings demonstrate an absence of covert recognition effects for M.S., consistent with the view that his impairment is primarily "perceptual" in nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/18. Liquefactive necrosis in Coxsackie B encephalitis.Coxsackieviruses may cause serious illness in infants and children, specifically myocarditis and meningoencephalitis. central nervous system lesions have been characterized as inflammatory in nature with mononuclear cell infiltration, neuronophagia, and glial nodule formation largely confined to the brain stem and spinal cord. We present two infants with documented Coxsackie B virus infection who also had widespread multifocal areas of liquefaction necrosis unassociated with inflammation. Such areas of bland necrosis, especially in the cerebrum, are unusual in Coxsackie B virus infection, and may provide the morphological substratum of permanent neurologic impairment in children who survive.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/18. phaeohyphomycosis of brain: granulomatous encephalitis caused by Drechslera spicifera.Drechslera spicifera is a dematiaceous fungus which occurs widely in nature but only rarely has been implicated in animal and human infections. Previous infections have occurred in superficial and subcutaneous sites or were encountered in immunologically compromised hosts. This report documents a case of granulomatous encephalitis due to Drechslera spicifera in an immunologically competent woman with no known underlying disease, from whom the fungus was isolated. Animal pathogenicity studies in mice reproduced the histopathologic features, and the fungus was reisolated from the animals.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/18. Chronic brainstem encephalitis with mental symptoms and ataxia: report of three cases with necropsy.Three necropsied cases of chronic, sporadic brainstem encephalitis of unknown aetiology are presented. Since their outstanding symptoms were dementia and ataxia of a progressive nature, a noninflammatory disease of the central nervous system was suspected. Neuropathological studies showed chronic inflammatory changes mainly in the brainstem without the presence of inclusion bodies or viral particles. Compared to cases previously reported as brainstem encephalitis, the clinical and pathological findings observed in these cases have rather peculiar characteristics.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/18. Computerized tomography as a diagnostic aid in acute hemorrhagic leukoencephalitis.Computerized tomography (CT) in a pathologically proven case of acute hemorrhagic leukoencephalitis (AHL) showed a mass effect and increased absorption coefficient in the right hemisphere within 18 hours of the onset of neurological symptoms. The changes corresponded to the site of white matter edema, necrosis, and petechial hemorrhages demonstrated postmortem. The early changes of CT reflect the hyperacute nature of AHL and differ from those of herpes simplex encephalitis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/18. The anterograde and retrograde retrieval ability of a patient with amnesia due to encephalitis.A patient with amnesia due to encephalitis was previously described in 1976 as having normal short-term memory and an intact ability to perform semantic analysis. Despite this ability, his retention beyond the limits of short-term memory was nearly nil. The present investigation sought to evaluate more completely the nature of this patient's retrieval deficit using a series of paradigms developed subsequent to his initial testing. Once again it was discovered that while his intact analytic abilities allowed retention of material in working memory, as soon as that working capacity was exceeded, retrieval of information became nearly impossible. It became apparent that the patient could not discriminate between a cue's most recently analyzed associate and the strongest existing associate to that cue in his semantic hierarchy. An analysis of his retrograde memory ability showed that he could retrieve almost no real episodes of either a public or private nature from his past. Instead, he seemed to rely on generalizations from his semantic memory to reconstruct "probable" events.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
| | Next -> |