1/10. Human herpesvirus-6 (HHV-6)-associated hemophagocytic syndrome.Virus-associated hemophagocytic syndrome (VAHS) is characterized by histiocytic proliferation and phagocytosis triggered by virus infections. viruses in the herpes group, especially the Epstein-Barr virus (EBV), are well known to cause VAHS; however, the relationship between this syndrome and human herpesvirus-6 (HHV-6) infection has rarely been reported. In this study, we describe a 23-month-old girl who exhibited typical manifestations of VAHS associated with HHV-6 infection. To the best of our knowledge, this case is the fifth reported case in the English literature.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
2/10. Bone marrow failure associated with human herpesvirus 8 infection after transplantation.BACKGROUND: Human herpesvirus 8 (HHV-8) infection has been linked to the development of Kaposi's sarcoma and to rare lymphoproliferative disorders. methods: We used molecular methods, serologic methods, in situ hybridization, and immunohistochemical analyses to study HHV-8 infection in association with nonmalignant illnesses in three patients after transplantation. RESULTS: Primary HHV-8 infections developed in two patients four months after each received a kidney from the same HHV-8-seropositive cadaveric donor. Seroconversion and viremia occurred coincidentally with disseminated Kaposi's sarcoma in one patient and with an acute syndrome of fever, splenomegaly, cytopenia, and marrow failure with plasmacytosis in the other patient. HHV-8 latent nuclear antigen was present in immature progenitor cells from the aplastic marrow of the latter patient. Identification of the highly variable K1 gene sequence of the HHV-8 genome in both the donor's peripheral-blood cells and the recipients' serum confirmed that transmission had occurred. HHV-8 viremia also occurred after autologous peripheral-blood stem-cell transplantation in an HHV-8-seropositive patient with non-Hodgkin's lymphoma. Reactivation of the infection was associated with the development of fever and marrow aplasia with plasmacytosis; there was no evidence of other infections. HHV-8 transcripts and latent nuclear antigen were expressed in the aplastic marrow but not in two normal marrow samples obtained before transplantation. CONCLUSIONS: Primary HHV-8 infection and reactivation of infection may be associated with nonneoplastic complications in immunosuppressed patients.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
3/10. Fulminant disseminated Varicella Zoster virus infection without skin involvement.BACKGROUND: Varicella Zoster virus (VZV) infection is potentially very serious in bone marrow transplant recipients, and may manifest as a disseminated visceral infection. This condition is generally accompanied by a vesicular rash. OBJECTIVES: We review here a case of fulminant fatal disseminated VZV infection, not accompanied by skin involvement, and the laboratory approaches currently available to diagnose this disease. STUDY DESIGN: Post mortem tissue samples were subjected to histopathological examination, and tested for herpesviruses by electron microscopy and PCR. RESULTS: Intranuclear inclusions were noted by histological examination in the lungs, liver, kidneys and bone marrow. Particles with a herpesvirus morphology were visualized in liver tissue. VZV dna was detected in liver and bone marrow by PCR followed by sequencing of the amplicons. viremia was documented by retrospective testing of the serum by PCR. CONCLUSIONS: A disseminated VZV infection which proved rapidly fatal was demonstrated in a case without skin manifestations. This rare presentation of VZV infection is potentially underdiagnosed. Testing for VZV viremia by PCR can at the very least suggest the diagnosis although whether plasma-associated viremia is truly pathognomonic of visceral disseminated infection remains to be established.- - - - - - - - - - ranking = 0.4keywords = herpesvirus (Clic here for more details about this article) |
4/10. Severe pancytopenia and hemophagocytosis after HHV-8 primary infection in a renal transplant patient successfully treated with foscarnet.We report the occurrence of human herpesvirus (HHV)-8 primary infection in an adult male kidney recipient. Four months after transplantation, the patient developed visceral Kaposi sarcoma, and 1 month later he presented with progressive and severe peripheral cytopenia, in the presence of a normocellular or hypercellular bone marrow (BM) with hemophagocytosis. HHV-8 was the sole pathogen detected by polymerase chain reaction either in the serum or in the BM. HHV-8 latent nuclear antigen was detected in immature progenitor cells from the BM. Immunosuppressive therapy was reduced, and the patient was treated with foscarnet for 2 weeks, leading to a dramatic normalization of blood cell counts, concomitantly with the disappearance of HHV-8 viremia. At the end of antiviral therapy, the patient received chemotherapy, and Kaposi sarcoma regressed in 2 months. Severe peripheral cytopenia may be a posttransplant complication after HHV-8 infection, for which treatment with foscarnet seems appropriate.- - - - - - - - - - ranking = 0.2keywords = herpesvirus (Clic here for more details about this article) |
5/10. Endonuclease analyses of dna of human herpesvirus-6 isolated from blood before and after bone marrow transplantation.Three strains of human herpesvirus-6 (HHV-6) were isolated from peripheral blood mononuclear cells of a leukemic child with the antibody of HHV-6 before and after bone marrow transplantation (BMT); two strains were obtained before BMT and one after BMT. The dna extracted from the three isolates was analyzed by six different restriction endonucleases. The cleavage profiles of two strains obtained before BMT were different, but the third strain isolated after BMT was identical with one of the two, which suggest reactivation of HHV-6 from the recipient's own body after BMT and possible mutation or super-infection of the virus in an immunocompromised patient.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
6/10. Herpesvirus infection of the respiratory tract in patients with alcoholic hepatitis.Respiratory herpesvirus infections have rarely been described in alcoholics. We report four cases of severe respiratory herpesvirus infections in patients with alcoholic liver disease. Two were related to herpes simplex Virus and two to cytomegalovirus. Both chronic alcoholism and severe liver disease induce immunosuppression, which might account for these unusual herpesvirus infections of the respiratory tract. These cases suggest that infections with herpesviruses should be considered in patients with alcoholic liver disease and pulmonary or tracheobronchial disease unresponsive to standard antibiotic therapy. bronchoscopy, viral culture, and serological tests appear warranted, particularly given the existence of specific therapy.- - - - - - - - - - ranking = 0.8keywords = herpesvirus (Clic here for more details about this article) |
7/10. Atypical clinical features of a human herpesvirus-6 infection in a neonate.A case of neonatal human herpesvirus 6 (HHV-6) B infection is presented. Although HHV-6 B was isolated from peripheral blood at the onset of the illness, a significant increase in viral antibody titers was not observed. The patient had a slight fever with generalized maculopapular skin rash and an increased number of atypical lymphocytes, which is quite different from the typical clinical features of exanthem subitum.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
8/10. Human herpesvirus-8-related Kaposi's sarcoma after liver transplantation successfully treated with cidofovir and liposomal daunorubicin.The iatrogenic form of Kaposi's sarcoma (KS) is typically observed among transplant recipients, and the most appropriate therapeutic approach (usually including reduction of immunosuppression, specific chemotherapy, and/or administration of antiviral agents against human herpes virus-8) is still controversial. Available experiences on the effect of the anti-herpes viruses drug cidofovir provide conflicting results. Herein, we report the clinical, histological, and virological features of a liver transplant recipient successfully treated with a combined therapy of cidofovir and liposomal daunorubicin, associated with a reduction of the immunosuppressive regimen, for an advanced cutaneous and visceral KS.- - - - - - - - - - ranking = 0.8keywords = herpesvirus (Clic here for more details about this article) |
9/10. Clinical features of primary human herpesvirus-6 infection in an infant with acute lymphoblastic leukemia.PURPOSE: The primary infection with human herpesvirus-6 developed concurrently with diagnosis of acute lymphoblastic leukemia and initiation of intensive chemotherapy for the disease in a 4-month-old girl. RESULTS: Prolonged viremia persisted for 7 days in the presence of neutralizing antibodies, and clinical features such as prolonged febrile and diarrheal period, no appearance of skin rash, and marked bulging fontanelle for 7 days in the absence of the virus dna in spinal fluid may suggest an atypical clinical course of exanthem subitum and an unusual viral replication in immunocompromised condition.- - - - - - - - - - ranking = 1keywords = herpesvirus (Clic here for more details about this article) |
10/10. Retinal perivasculitis in an immunocompetent patient with systemic herpes simplex infection.PURPOSE: To describe a case of retinal perivasculitis in an immunocompetent patient with systemic herpes simplex infection. methods: polymerase chain reaction amplifications were performed for aqueous and blood samples using primers specific for the following members of the herpesvirus family: cytomegalovirus, Epstein-Barr virus, herpes simplex virus (types 1 and 2), and varicella-zoster virus. The patient was placed on intravenous acyclovir and systemic corticosteroids. RESULTS: A positive polymerase chain reaction signal was found only for herpes simplex virus type 1. Vision in the left eye improved from light perception to 20/25, and signs of retinal perivasculitis resolved. CONCLUSION: The use of molecular diagnostic modalities in clinical practice may aid in determining infectious etiologies in patients with atypical clinical manifestations.- - - - - - - - - - ranking = 0.2keywords = herpesvirus (Clic here for more details about this article) |
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