1/3. early diagnosis of Murray Valley encephalitis by reverse transcriptase-polymerase chain reaction.A 4-year-old aboriginal boy developed encephalitis due to Murray Valley encephalitis virus (MVE) following an earlier infection with Kunjin virus (KUN). The illness was severe, resulting in cerebral atrophy and profound physical and intellectual disability. The earlier KUN infection complicated his serological profile and delayed antibody responses to MVE. By contrast, the reverse transcriptase-polymerase chain reaction (RT-PCR) assay detected MVE in serum 3 days after the onset of illness and 4 days before the appearance of MVE-specific IgM. We suggest that MVE-specific RT-PCR provides rapid and specific diagnosis of MVE and should be used more widely for the diagnosis of acute viral encephalitis in cases originating from flavivirus endemic areas.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. Meningo-encephalitis presenting as an acute paranoid psychosis.A twenty-seven year old women with meningo-encephalitis and paranoid symptoms is presented. The patient was admitted to a psychiatric unit where, two months previously, her brother had been under treatment for a paranoid schizophrenic episode. The diagnostic lumbar puncture was performed after several days of increasing periods of disorientation, stupor, incontinence, posturing, and perseveration. There was no fever, no signs of meningeal irritation, and no localizing neurologic deficit. The problem of recognizing organic brain disease presenting as an acute psychotic episode is discussed. In this case, the positive family history was given inappropriate emphasis, while the good pre-morbid adjustment of the patient and the symptoms of confusion and headache were inadequately considered. Viral meningo-encephalitis, particularly that due to herpes simplex, often presents with a picture of behavioral abnormalities and minimal physical signs, and is easily confused with a functional process.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/3. Trial with human leucocyte interferon and vidarabine in herpes simplex virus encephalitis: diagnostic and therapeutic problems.A combination therapy of human interferon, vidarabine, and dexamethasone was administered to six patients with proven (patients I-III) or presumed (patients IV-VI) herpes simplex virus encephalitis (HSVE). Interferon combined with dexamethasone was given to one patient with presumed HSVE (Patient VII). Leucopenia and elevated serum transaminase levels appeared in all patients and a diffuse bleeding in one of them. patients II, III and IV died, 26, 43, and 209 days after the onset of encephalitis, respectively. patients I, V, VI, and VII were left with moderate brain damage although their physical condition was good. HSV encephalitis presents diagnostic difficulties, complementary diagnostic methods are needed, and current therapeutic trials must be considered as preliminary.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |