11/586. rothmund-thomson syndrome with herpes encephalitis.A 4-year-old Japanese boy with rothmund-thomson syndrome suffered from severe herpes encephalitis at 5 months of age. The serum level of immunoglobulin g was low and the responsiveness of peripheral blood mononuclear cells to bacterial superantigens was poor. It was suggested that these immunological abnormalities, possibly associated with rothmund-thomson syndrome, led to severe infection with herpes simplex virus in our patient.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
12/586. Nucleotide sequence of thymidine kinase gene of sequential acyclovir-resistant herpes simplex virus type 1 isolates recovered from a child with Wiskott-Aldrich syndrome: evidence for reactivation of acyclovir-resistant herpes simplex virus.Recurrent acyclovir (ACV)-resistant (ACV-r) herpes simplex virus type 1 (HSV-1) infections occurred in a patient with wiskott-aldrich syndrome, an X-linked recessive immunodeficiency syndrome composed of three clinical characteristics of immunodeficiency, thrombocytopenia, and an eczematous dermatitis. The patient had severe and recurrent ACV-r herpes simplex and was treated with vidarabine in a satisfactory manner from 1993 to 1997. During the 4-year observation period, two ACV-sensitive (ACV-s) HSV-1 isolates and five ACV-r HSV-1 isolates were recovered. The nucleotide sequence of the thymidine kinase (TK) gene from these sequential ACV-r isolates was compared with the ACV-s isolates. A single nucleotide deletion of cytosine (C) from homopolymer stretch of four C residues between nucleotide 1061 and 1064 of the open reading frame was found in all ACV-r isolates. No other differences were observed in the TK nucleotide sequence between ACV-s and ACV-r isolates. The TK nucleotide sequences of the two ACV-s isolates were identical to each other and those of the five ACV-r isolates were identical to one another. These results suggest that the ACV-r HSV-1 might have derived from the ACV-s strain in the patient body and that TK-associated ACV-r HSV-1 can reactivate from latency.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
13/586. Diagnosis of esophageal ulcers in acquired immunodeficiency syndrome.The esophagus is one of the most common sites of gastrointestinal involvement in human immunodeficiency virus (HIV)-infected patients, with at least 30% of the patients having esophageal symptoms at some point during the course of HIV infection. Esophageal ulcers are commonly caused by infections such as cytomegalovirus (CMV) or may be idiopathic. The clinical presentation of the various causes of esophageal ulcers are similar; therefore, a thorough endoscopic and histological workup is imperative to make a diagnosis and, consequently, to provide appropriate therapy. The widespread use of more effective antiretroviral therapy appears to have led to a decline in gastrointestinal opportunistic disorders in patients with acquired immunodeficiency syndrome (AIDS), including those involving the esophagus. Unfortunately, there are several reports of resistance of hiv-1 to multiple antiretroviral agents, and thus it is possible we will observe an increase in various opportunistic disorders again. The aim of this article is to provide a practical approach to the clinical, endoscopic, and histopathologic evaluation of esophageal ulcers in patients with AIDS.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
14/586. Successful treatment of generalized primary herpes simplex type 2 infection during pregnancy.Generalized herpes simplex virus infections constitute a severe threat to mother and child during pregnancy. Before antiviral treatments were available, both mother and foetus had a high mortality rate. The following case illustrates a successful outcome after long-term antiviral treatment. It is of great importance to suspect, diagnose and treat patients with HSV 2 early, especially during pregnancy.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
15/586. herpes simplex peritonitis: case report.It has been previously reported that the most common cause of peritonitis in patients undergoing chronic ambulatory peritoneal dialysis (CAPD) is infection by a single gram-positive bacterial species. Polymicrobial bacterial infections are identified that may be secondary to bowel perforation. In 20% of cases bacterial cultures are negative. Although cultures may be negative when infection is due to a fastidious organism, when antibiotic therapy has been administered, and in cases of chemical peritonitis, a viral etiology should also be considered. We report the first documented case of herpes simplex peritonitis, which involved a 60-year-old female undergoing CAPD. Viral peritonitis may be an important form of peritonitis that has been previously unrecognized and should be considered in the differential diagnosis.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
16/586. Herpetic whitlow in an AIDS patient.This case confirms that cutaneous herpes simplex virus (HSV) infections in many AIDS patients is important not only for the difficulty in diagnosis of herpetic lesions, but also for the possibility that co-infection by HSV and HIV can adversely affect prognosis in these patients.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
17/586. Herpetic tracheitis and brachial plexus neuropathy in a child with burns.Herpetic tracheobronchitis is a well-recognized clinical entity that most commonly occurs in immunocompromised patients, including patients with burns. Although the diagnosis of herpetic tracheobronchitis is usually not made until postmortem examination, the presence of the condition can be established when histologic specimens of a patient with upper airway obstruction are studied. In this article, a case is described in which a child developed herpetic tracheitis after undergoing elective intubation after the grafting of burns of the face, neck, and upper extremity. The tracheitis resulted in severe upper airway obstruction that required tracheal dilatation and sequential bronchoscopic excisions of granulation tissue. The patient also developed a brachial plexus neuropathy that was most likely related to herpetic infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
18/586. Herpes and the head and neck: the difficulties in diagnosis.A case of primary herpes of the head and neck is presented. The exact source of infection and the precise diagnosis proved difficult to establish, but evidence tended to support a diagnosis of varicella zoster infection as opposed to a herpes simplex infection, though a dual infection was not ruled out. herpes simplex has specific clinical features which usually make its distinction from varicella zoster clear cut. In this case we relied heavily on laboratory investigations to improve the accuracy of our diagnosis since the clinical characteristics were blurred. Unlike varicella zoster there has been little written about herpes simplex infections specifically affecting the ear, face and neck.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
19/586. Simultaneous reactivation of herpes simplex virus and varicella-zoster virus in a patient with idiopathic thrombocytopenic purpura.Simultaneous reactivation of distinct herpesviridae with development of clinical manifestations is exceptional. We report a 48-year-old woman suffering from idiopathic thrombocytopenic purpura. As the disease remained refractory to corticosteroids, immunoglobulins and splenectomy, a cure of vinblastine was administered. An atypical stomatitis developed few days later. immunohistochemistry on a Tzanck smear and a biopsy evidenced a herpes simplex virus type 1 (HSV-1) infection. The patient presented simultaneously a single necrotic lesion on the abdomen. immunohistochemistry on a skin biopsy revealed the presence of the varicella-zoster virus (VZV) gE, gB and IE63 proteins. Intravenous aciclovir was initiated. The present case of simultaneous clinical infections by HSV-I and VZV underlines the importance of complementary viral identification testing in the event of unusual clinical presentations.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
20/586. Identification and treatment of herpes lesions.Infections caused by the herpes family of viruses are on the rise. Mucocutaneous herpes infections are caused by herpes simplex viruses 1 and 2 and varicella-zoster virus. herpes simplex virus commonly causes oral-labial or genital infection, and varicella-zoster virus causes chicken pox and shingles. Clinical features frequently are atypical, particularly in compromised patients. Therefore, a high index of suspicion must be maintained for early diagnosis. Availability of easy-to-perform rapid diagnostic tests and several potent antiherpetic agents have vastly improved the management of herpes infections.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
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