1/8. Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used?Allergic contact dermatitis caused by acyclovir is rare. We report the 5th case of systemic acyclovir reaction subsequent to acyclovir contact dermatitis, with investigations made to determine an alternative antiviral treatment. A 23-year-old woman, after dermatitis while using Zovirax cream, went on to develop urticaria after oral acyclovir. patch tests were performed with the components of Zovirax cream (acyclovir, propylene glycol and sodium lauryl sulfate) and with other antiviral drugs. patch tests were positive to Zovirax cream, acyclovir, valacyclovir and propylene glycol. Patch and prick tests with famciclovir were negative, but its oral administration caused an itchy erythematous dermatitis on the trunk and extremities. Our patient developed a systemic acyclovir reaction subsequent to acyclovir allergic contact dermatitis, with cross-reactions to valacyclovir and famciclovir. Their common chemical structure is the 2-aminopurine nucleus. It is probably this part of the molecule that provokes both contact allergy and systemic reactions. The only antiviral drugs not having this core are foscarnet and cidofovir, and these could therefore be alternatives.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
2/8. Double encephalitis with herpes simplex virus and cytomegalovirus in an adult.A 51-year-old housewife developed symptoms of a cold followed by high fever, delirium, coma, rigidity of extremity muscles, positive Babinski sign and generalized convulsions, while complement-fixing antibody titre to herpes simplex virus in the sera raised over 128 X and declined to 8 X in the course. She finally expired of bronchopneumonia following status epilepticus after 94 days of illness. Severe necrosis with extensive hemorrhage in the white matter was predominant in the temporal, insular and orbitofrontal cortex, thalamus and globus pallidus. Focal rarefaction of the cerebral cortex with a very few eosinophilic intranuclear inclusions in the oligodendroglia and nerve cells, nerve cell destruction in the substantia nigra with glial nodules and perivascular inflammatory cell cuffs were observed. Abundant cytomegalic inclusion cells, originating from hypertrophic astrocytes, were present in the necrotic areas of cerebrum as well as in the rarefied tissue in the subependymal layers of the brainstem and cerebellum. Electron-microscopic study of the cytomegalic cells demonstrated the presence of numerous virions in both nucleus and cytoplasm. Fortuitour infection of the brain by cytomegalovirus with necrotizing encephalitis by herpes simplex virus is unique. The cause of double viral infections and severe lesions by less virulent strains is discussed.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
3/8. herpes simplex lymphadenitis. Report of two cases with review of the literature.We report two cases of herpes simplex lymphadenitis without widespread organ involvement in a 60-year-old man and a 67-year-old woman. Their complaints were high fever and generalized erythema followed after few days by generalized lymphadenopathy. This report describes the findings obtained by light and electron microscopy, immunohistochemistry, and in situ hybridization. In both instances, Cowdry's type A intranuclear inclusion bodies were found in T-immunoblasts in the background of T-zone hyperplasia with focal necrosis. Electron microscopic investigation revealed intranuclear and cytoplasmic virus particles with characteristics of the herpes group. Immunohistochemical staining utilizing anti-herpes simplex virus (HSV) antibody was positive and in situ hybridization with HSV-dna probe revealed positive signals in the nucleus and in the cytoplasm of T-immunoblasts. Although rare, HSV lymphadenitis in the absence of generalized infection can occur.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
4/8. Haemorrhage in neonatal hepatic necrosis due to herpes infection.A case of early neonatal severe bleeding and persistent hypoglycemia with a fatal outcome is reported. The autopsy examination revealed the features of neonatal hepatic necrosis. Further study by the electron microscopy indicated the presence of herpes type particles in the nucleus and cytoplasm of the remaining liver cells. Serological study of the maternal blood, post partum, revelaed positive reaction to herpes simplex virus type 2 at low titer. It is believed that intrauterine herpes infection was responsible for the severe hepatic damage manifesting in complex clinical findings.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
5/8. herpes simplex-hepatitus use of immunoperoxidase to demonstrate the viral antigen in hepatocytes.In this paper we describe 2 patients with herpes simplex hepatitis. Submassive liver necrosis occurred in both patients, one of whom survived. Notable in the clinical course of both patients was the almost simultaneous occurrence of three events-fever, marked elevation of serum transaminases, and leukopenia. Using an immunoperoxidase staining technique we demonstrated herpes simplex viral antigen in the nucleus, cytoplasm, and cell membrane of affected hepatocytes.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
6/8. Unusual membrane bound intranuclear inclusions in human fibroblasts infected with herpes simplex.Examination of brain tissue taken at autopsy from a 55-year old male showed the presence of herpes simplex viral antigen by immunofluorescence techniques. A suspension of this tissue was inoculated into cultures of human diploid fibroblasts. After 72 h, viral particles at different stages of development were seen inside the nuclei. Envelopment of the viral particles seemed to occur in association with the nuclear membranes, endoplasmic reticulum, cytoplasmic vacuoles and plasma membranes. Severely altered nuclear membranes, with as many as 4 to 8 layers of nuclear envelope, emphasized the common occurrence of membrane reduplication associated with herpes simplex infection. Unusual membrane-bound, dense, rounded inclusions, 100 to 500 nm in diameter, were present in the nucleus. These inclusions apparently were formed between the inner and outer lamellae of the nuclear membrane.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
7/8. Slowly alternating skew deviation: description of a pretectal syndrome in three patients.Three patients who had slowly alternating skew deviation are described; each had elements of the Sylvian aqueduct syndrome. This combination of signs supports a pretectal location for lesions associated with alternating skew movements. Postmortem examination of a patient who died of chronic herpes simplex encephalitis showed extensive demyelination and periaqueductal spongiform degeneration; there was preservation of the oculomotor and trochlear nuclei, the medial longitudinal fasciculus, vestibular nuclei, and the interstitial nucleus of Cajal bilaterally. The slowly alternating dysconjugate vertical movements bear a resemblance to both see-saw nystagmus and the ocular tilt response.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |
8/8. A case of Bickerstaff's encephalitis. With special reference to neurotological findings.The case of a 60-year old male with prodromal common cold symptoms and progression of brain stem involvement with no cardiac or respiratory complications is described. This conformed to the criteria of Bickerstaff's encephalitis. Neurotological examinations, including the OKN test, the caloric test, and the GBST were performed from onset to recovery of the disease. The results of these tests closely reflected the central nervous system disorders each time, but there was a discrepancy in the results of the two test batteries of equilibrium function, the caloric test and the GBST. The caloric test showed bilateral canal paresis while the GBST showed normal responses. These results suggested that the involved area of the vestibular nucleus was localized to the superior portions. Form our clinical observations, we can conclude that neurotological examinations provide more vital information for localized diagnosis and follow-up of the brain stem lesion in Bickerstaff's encephalitis.- - - - - - - - - - ranking = 1keywords = nucleus (Clic here for more details about this article) |