1/6. Acute transient pseudoatrophy of the brain accompanying measles infection.Two infants, age 1 year, with acute encephalopathy who showed transient pseudoatrophy of the brain were reported. They each had measles infection, followed by 'mild drowsiness'. Reversible brain atrophy has been observed in patients with undernutrition, dehydration, and overdoses of steroids and valproic acid. However, these manifestations were very mild and there was no history of drug administration in our patients. The cause of the transient brain pseudoatrophy was unknown. However, activation of glial cells accompanying the measles infection was thought to be one possibility to see high value of neopterin (51 pmol/l) in the cerebrospinal fluid in one case. Although 'mild drowsiness' is not a rare manifestation in patients with measles infection, it is probable that their 'mild drowsiness' is caused by acute encephalopathy like in our cases. Thus, we recommend that computed tomography scanning or magnetic resonance imaging is performed in patients showing 'mild drowsiness' during measles infection.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/6. Severe measles in immunocompromised patients.OBJECTIVE--To describe the severity of measles in immunocompromised hosts and to assess preventive and therapeutic modalities. DATA SOURCES--patients admitted to two academic medical centers between September 1989 and December 1990 and English language references obtained by medline from 1963 to 1991. Bibliographies were used to identify reports prior to 1963. STUDY SELECTION--We identified nine immunocompromised patients with measles. Further analysis was based on 35 patients from two cohort studies of measles in oncology patients and 24 reported cases of measles in human immunodeficiency virus (hiv)-infected patients. DATA EXTRACTION--Clinical data are presented from the nine patients we treated. Information concerning measles complications, presence of rash, use of prophylactic immunoglobulin, and therapeutic measures was extracted from the literature. DATA SYNTHESIS--Of our nine patients, eight developed severe complications and two died. Two patients had no rash. In combining our patients with those from the literature, severe complications occurred in about 80%. The case fatality rate for severe measles was about 70% for oncology patients and about 40% for hiv-infected patients. Rash was absent in about 30%. The efficacy of prophylactic or therapeutic measures could not be assessed due to the small number of patients. However, we observed a rapid defervescence following administration of ribavirin. Vaccinated, hiv-infected patients had a lower mortality rate than those not previously vaccinated (P = .06). CONCLUSIONS--Measles is a severe illness in immunocompromised patients, and the absence of rash is frequent. While treatment is supportive, ribavirin requires further study. measles vaccine may be efficacious in hiv-infected patients. vaccination of oncology patients should be reassessed.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/6. role of CSF serology in follow-up of subacute sclerosing panencephalitis patients on treatment.subacute sclerosing panencephalitis (SSPE) is a progressive inflammatory disease of the central nervous system with poor prognosis and high mortality. No effective treatment has a proven role; oral isoprinosine and intrathecal administration of alpha-interferon may prolong survival. We report an unusual case of adult onset SSPE patient on treatment with significant clinical improvement, even in the absence of conversion to seronegativity in either CSF or serum, on follow-up serological examination.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/6. Immunosuppressive measles encephalitis in a patient with a renal transplant.An inclusion body encephalitis developed in a patient with a renal transplant that was shown by immunofluorescence and electron microscopic studies to be due to measles virus. Measles encephalitis may be an opportunistic infection in children and adults with immunodeficiencies secondary to tumors or to the administration of immunosuppressive drugs.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/6. Pure red cell aplasia associated with sodium valproate therapy.Pure red cell aplasia developed in a 9-year-old girl receiving sodium valproate therapy. infection with measles and chickenpox had occurred two months previously. regeneration of bone marrow erythroid precursors was demonstrated one month after drug withdrawal. Readministration of sodium valproate resulted in a second episode of red cell aplasia that again resolved promptly after drug withdrawal. The respective roles of infection and drugs in the etiology of red cell aplasia are discussed.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/6. Disseminated measles infection after vaccination in a child with a congenital immunodeficiency.An infant boy with a congenital immunodeficiency had fatal disseminated measles after administration of a live attenuated measles vaccine. This rare complication was confirmed with molecular virologic techniques. Although efforts to expand availability of vaccinations are critically important, caution is warranted in children with potentially severe immunologic dysfunction.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |