RESUMO
Using deep sequencing, human immunodeficiency virus (HIV) resistance-associated mutations were detected as minority species in the cerebrospinal fluid (CSF) of 4 patients with higher HIV type 1 RNA load in CSF than in plasma, but not in 2 patients with higher plasma viral load. Deep sequencing could help our understanding of viral escape in the central nervous system.
Assuntos
Líquido Cefalorraquidiano/virologia , Variação Genética , Infecções por HIV/virologia , HIV-1/classificação , HIV-1/genética , Adulto , Farmacorresistência Viral , Feminino , HIV-1/efeitos dos fármacos , HIV-1/isolamento & purificação , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Estudos Retrospectivos , Carga ViralRESUMO
Neurological manifestations and outcomes of children with the 2009 H1N1 virus infection have been reported in three American series and from smaller cohorts and case reports worldwide. Of the 83 children admitted between April 2009 and March 2010 with H1N1 virus infection to a tertiary children's hospital in a European setting, five children aged between 2 and 10 years had neurological symptoms. Four patients had seizures and encephalopathy at presentation. One patient presented with ataxia; one developed neuropsychiatric manifestations, and two developed movement disorders during the disease course. Early neuroimaging showed evidence of acute necrotising encephalopathy (ANE) in one case and non-specific white matter changes in another. Initial neuroimaging was normal for the other three, but interval MRI showed increased signal in bilateral periventricular distribution in one and significant cerebral volume loss in the other. Clinical outcomes varied: two recovered fully while three had residual seizures and/or significant cognitive deficits. Conclusion An analysis of our patients along with all reported cases reveal that seizures and encephalopathy were common neurological presentations associated with pandemic 2009 H1N1 influenza virus infection in children requiring hospital admission. Neuroimaging suggestive of ANE, basal ganglia involvement and volume loss appears to be associated with worse neurological outcome.
Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/complicações , Doenças do Sistema Nervoso/etiologia , Adolescente , Criança , Pré-Escolar , Encefalite Viral/virologia , Feminino , Humanos , Lactente , Influenza Humana/líquido cefalorraquidiano , Influenza Humana/diagnóstico , Masculino , Convulsões/etiologiaAssuntos
Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/fisiologia , Hepatite B/imunologia , Hepatite B/virologia , Replicação Viral , Idoso , Genoma Viral , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/sangue , Anticorpos Anti-Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Humanos , Testes de Função Hepática , Masculino , Mutação , Carga ViralRESUMO
A total of 8 infants presenting with sepsis-like illness were diagnosed to have human parechovirus (HPeV) infection; of which, 5 had abdominal distension and 6 had an erythematous rash. A combination of abdominal distension and erythematous rash was observed in 4 infants. The abdominal symptoms can be very prominent and signs could be confused with acute surgical conditions. Although fever and central nervous symptoms are important features, a red rash with abdominal distension and a low C-reactive protein value and lymphocyte count can be clues to recognize this infection.