1/9. Concurrent herpes simplex type 1 and varicella-zoster in the V2 dermatome in an immunocompetent patient.A unique feature of herpesviruses is their ability to establish latent infection within the nervous system by colonizing peripheral sensory ganglia, which results in subsequent episodic outbreaks of infection triggered by precipitating events. Despite the latent nature of both herpes simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) within these sensory ganglia, simultaneous outbreaks of these viruses are uncommon. This is generally attributed to the differing reactivation features of these 2 viruses. Four cases of concurrent HSV-1 and VZV infection are described in the literature. We report concurrent infection of HSV-1 and VZV within the same V2 dermatome in an immunocompetent patient.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/9. role of viral serology in the diagnosis of acute retinal necrosis syndrome.Due to the devastating nature of acute retinal necrosis syndrome (ARNS), early diagnosis is essential. 5 cases of clinically diagnosed ARNA were investigated for CMC, herpes simplex and varicella zoster virus (VZV) infections. Of the three VZV IgM positive cases, two were positive in acute blood samples and one in vitreous fluid. Thus VZU can be incriminated as the causative agent of ARNS cases in North india.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/9. Sequestered viscoelastic after deep lamellar keratoplasty using viscodissection.PURPOSE: Deep lamellar keratoplasty (DLKP) is an intricate procedure that preserves the host's endothelium, thus eliminating the possibility of endothelial graft rejection and potentially offering great benefits over penetrating keratoplasty. DLKP may be performed by a variety of techniques including viscodelamination, in which the stroma is separated from Descemet's membrane using viscoelastic. methods: Here we present an operative complication of this technique, which was not initially recognized, that caused significant morbidity to our patient and eventually led to the eye requiring a full thickness regraft. We also attempt to reproduce the lesion using nonviable cadaver corneas and illustrate histologically the nature of the corneal stroma and its relationship to Descemet's membrane following viscoelastic delamination.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/9. Unilateral retrobulbar optic neuritis due to varicella zoster virus in a patient with AIDS: a case report and review of the literature.Unilateral retrobulbar optic neuritis developed in a 43-year-old man with acquired immune deficiency syndrome (AIDS). This was secondary to varicella zoster virus (VZV) as confirmed by cerebrospinal fluid (CSF) polymerase chain reaction (PCR) detection of VZV in the cerebrospinal fluid. There was no typical cutaneous infection and no evidence of retinitis. The onset of unexplained visual loss due to optic neuritis in hiv positive individuals may be due to VZV infection. Prompt recognition, and early intervention with antiVZV therapy may preserve vision. Retrobulbar optic neuritis secondary to VZV infection should be considered in immunocompromised patients even in the absence of cutaneous or retinal lesions. Previous cases are reviewed and the varied nature of viral transport in the nervous system is noted.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/9. 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) |
6/9. Prolonged cutaneous herpes zoster in acquired immunodeficiency syndrome.We described the development of prolonged disseminated cutaneous herpes zoster in two patients with acquired immunodeficiency syndrome. Both patients developed hyperkeratotic, verrucous lesions that progressed despite acyclovir therapy. The biopsy specimens were typical of herpes infection. The development of acyclovir-resistant varicella-zoster virus during therapy was suspected clinically in the first patient and documented in vitro in the second patient. The inability to mount an effective cell-mediated immune response contributed to the prolonged course of cutaneous zoster in our patients. The hyperkeratotic nature of the skin lesions may reflect their chronic nature. Treatment with inadequate doses of acyclovir, allowing viral persistence and the selection of resistant strains of virus, may also be implicated. We recommend prolonged high-dose intravenous acyclovir therapy in the initial management of herpes zoster in patients with acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
7/9. MRI findings in two cases of acute facial paralysis.This article describes the use of magnetic resonance imaging (MRI) in the evaluation of the facial nerve paralysis of Bell's palsy and herpes zoster oticus. Identification of the nature of inflammatory facial nerve paralysis often presents a diagnostic dilemma. The site of involvement along the course of the nerve may have importance when treatment options are being considered. We have found MRI to be a unique method for localizing the site of nerve injury in both Bell's palsy and Ramsay Hunt syndrome.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/9. Herpes zoster: a consideration in the differential diagnosis of radiculopathy.Herpes zoster probably occurs more often than generally thought. Since it produces a radicular distribution of pain, it should be included in the differential diagnosis of radiculopathy. A case is presented in which evaluating the radicular low back pain before the characteristic rash appears was misleading. Careful history-taking concerning the exact nature of the pain and sensory changes is needed to differentiate between zoster and radiculopathy, if no rash is evident.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/9. Transient gastroparesis associated with cutaneous herpes zoster.We report a patient who developed delayed gastric emptying with vomiting and weight loss simultaneously with herpes zoster in the sixth right thoracic dermatome. Sequential radionuclide solid egg meal gastric emptying studies were used to document gastroparesis, the response to metoclopramide and its transient nature. We present a possible explanation for this phenomenon within the context of the known pathophysiology of varicella-zoster infection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |