1/28. Encephalopathy associated with haemophagocytic lymphohistiocytosis following rotavirus infection.A 2-year-old Japanese boy with a haemophagocytic lymphohistiocytosis (HLH) associated encephalopathy which developed after rotavirus infection is described. The neurological symptoms consisted of coma, seizures and spastic quadriplegia. On therapy with steroids, etoposide and cyclosporin A, the patient recovered without any neurological deficits. The interferon-gamma levels in serum and CSF were elevated at onset of the disease but had returned to normal at the time of clinical remission. brain MRI revealed diffuse white matter abnormalities and parenchymal volume loss. Proton magnetic resonance spectroscopy revealed elevated lactate in the abnormal lesions observed on MRI, indicating that macrophages not exhibiting aerobic metabolism had infiltrated the CNS. At the time of clinical remission, the white matter abnormalities and brain lactate had disappeared. These findings suggested that the neurological symptoms resulted from the overproduction of cytokines by activated T-cells and macrophages. The pathophysiology of a HLH associated encephalopathy was considered to be a local immune response within the CNS, because interferon-gamma can induce the expression of major histocompatibility complex class I and II antigens on glial cells in the CNS. CONCLUSION: Haemophagocytic lymphohistiocytosis associated encephalopathy should be considered early in the differential diagnosis of cases with acute onset neuropathy.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/28. Acute gastroenteritis in children.BACKGROUND: Acute gastroenteritis is a common childhood illness. Most cases are caused by rotavirus infection. OBJECTIVE: This article discusses the classic presentation of gastroenteritis in children, which includes a short history of vomiting followed by diarrhoea. DISCUSSION: dehydration is the main problem in children with gastroenteritis, and severe dehydration is a medical emergency. Mild to moderately dehydrated children can be safely treated at home with oral rehydration therapy, however parents require careful explanation of the disease, its course and potential complications. Early reintroduction of usual foods (breast milk, formula or solids) has been shown to shorten the illness. Babies may need to be reviewed within 8 hours and older children within a day.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
3/28. Histologic distribution of fatal rotaviral infection: an immunohistochemical and reverse transcriptase in situ polymerase chain reaction analysis.Rotaviral infection is the most common cause of gastroenteritis in young children. Although rotavirus infection has a high morbidity and mortality rate in animals, in most cases in the united states the disease appears to be self-limited in humans. We report on 2 cases of fatal rotaviral infection in a 1 year old and a 4 year old. In each case, the illness showed a rapid systemic course dominated by cardiac and central nervous system involvement; in one case, rotaviral infection was documented by stool culture. Viral rna was localized by reverse transcriptase in situ polymerase chain reaction to the mucosal cells of the small and large intestine and to many other tissues, including the heart and central nervous system, where it was noted in the endothelial cells of the microvasculature. Immunohistochemical analysis for the virus showed an identical histologic distribution in the intestinal epithelial cells and the systemic microvasculature. It is concluded that rotaviral infection can lead to a fatal disseminated infection in humans and the mechanism of this complication is based on a diffuse endothelialitis and concomitant tissue damage.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
4/28. rotavirus infection as cause of tacrolimus elevation in solid-organ-transplanted children.rotavirus (RV) is the most common cause of diarrheal illness in children. We report three solid-organ-transplanted patients in whom RV infection caused increased trough levels of the immunosuppressive macrolide tacrolimus (TAC) by mechanisms that are still under investigation. The virus was detected for longer in the feces of these patients than in infants not receiving immunosuppressive therapy. In association with short-term monitoring of blood trough levels of TAC, the dosage should be reduced early if symptoms of an acute gastroenteritis are present.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
5/28. Fatal, rotavirus-associated myocarditis and pneumonitis in a 2-year-old boy.rotavirus infection is common in childhood. We report a 2-year-old boy admitted to hospital with gastro-enteritis who suffered cardio-respiratory arrest and died. autopsy showed evidence of rotavirus-associated myocarditis and pneumonitis. We are not aware of any previous report of death from this type of consequence of rotavirus infection.- - - - - - - - - - ranking = 0.4keywords = infection (Clic here for more details about this article) |
6/28. Prolonged shedding of rotavirus in a geriatric inpatient.This study concerns a nosocomial rotaviral infection of a geriatric patient with clinical symptoms of acute gastroenteritis. The virological diagnosis was based on the detection of rotaviral antigens using a Rota kit, viral genome rna by reverse transcription-polymerase chain reaction method, and viral particles by electron microscopy in the stool samples. Prolonged rotaviral shedding was suggested to be due to impaired natural killer cell activity, possibly together with deficiency of specific local immune response of the patient.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
7/28. Histologic distribution of fatal rotaviral pneumonitis: an immunohistochemical and RT in situ PCR analysis.Rotaviral infection is a common cause of gastroenteritis and pharyngitis; to our knowledge, infection has not been associated with severe pneumonia. We report on two cases of fatal pneumonitis in 49-and 54-year-old men; the latter was on long-term steroid treatment of multiple sclerosis. In the latter case, the histologic examination after a several week history of symptoms showed severe organizing interstitital pneumonitis and necrotizing bronchiolitis with extensive squamous metaplasia. The other case, which was fatal several days after the onset of symptoms, showed marked septal capillaritis with denudement of the alveolar pneumocytes, extravascated red blood cells, and intravascular thrombi formation. In each case, rotaviral rna was localized by reverse transcription (RT) in situ PCR to the endothelial cells of the alveolar capillaries, macrophages, and pneumocytes as well as, in the second case, to the squamous metaplastic cells. Immunohistochemical analysis for the virus demonstrated an equivalent histologic distribution. It is concluded that rotaviral infection can lead to fatal pneumonitis and that the mechanism of this complication is centered on a diffuse septal endothelialitis with concomitant tissue damage.- - - - - - - - - - ranking = 0.6keywords = infection (Clic here for more details about this article) |
8/28. rotavirus gastroenteritis and central nervous system (CNS) infection: characterization of the VP7 and VP4 genes of rotavirus strains isolated from paired fecal and cerebrospinal fluid samples from a child with CNS disease.rotavirus rna was detected in the cerebrospinal fluid (CSF) of a child with central nervous system disease symptoms associated with rotavirus gastroenteritis. The rotavirus isolates from the fecal and CSF samples were genotyped as G1P[8]. sequence analysis of the VP7 and VP4 proteins derived from the fecal and CSF samples were remarkably similar to each other and to G1P[8] rotavirus strains commonly circulating in the community and associated with gastroenteritis.- - - - - - - - - - ranking = 0.8keywords = infection (Clic here for more details about this article) |
9/28. Protein-losing enteropathy in patients with Fontan circulation: is it triggered by infection?INTRODUCTION: Protein-losing enteropathy (PLE) is a recognised complication of the Fontan circulation. Its pathogenesis is not fully understood, however, and it is unclear why its onset occurs months or even years after Fontan surgery. patients: We report a 4.5-year-old girl with Fontan circulation who developed PLE almost 1 year after surgery. At the time of onset the patient had rotavirus enteritis and streptococcal tonsillitis. We have reviewed the records of seven other patients with longstanding PLE. In six of these patients we identified infections at the onset of symptoms. None of our patients had evidence of opportunistic infection. DISCUSSION AND CONCLUSION: The immune system of patients with PLE is compromised, but reports on recurrent opportunistic infections are rare. The present observations suggest that infection and inflammation may be associated with the onset of PLE. The mechanism of how infection may trigger PLE warrants further investigation.- - - - - - - - - - ranking = 1.8keywords = infection (Clic here for more details about this article) |
10/28. First case of confirmed rotavirus meningoencephalitis in germany.We report the case of a 9-year-old girl in germany with acute meningoencephalitis associated with rotavirus gastrointestinal infection. sequence analysis revealed a genetic relationship of the strain to rotaviruses with subgroup II specificity. reverse transcription-PCR was positive for rotavirus.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
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