RESUMEN
To study the outcome of mumps virus encephalitis 47 patients were contacted 1-15 years after the acute encephalitis associated with mumps virus infection. Twenty-three patients experienced clinical sequelae such as difficulties in memory and learning, focal motor or sensory signs, and loss of hearing and visual acuity. Lumbar puncture was performed on 8 patients. Antibodies to mumps virus were detected in 6 cerebrospinal fluid (CSF) specimens using enzyme immunoassay and in 3 patients an abnormal serum/CSF antibody ratio was observed 11, 26 and 58 (controls greater than 85); 14.3, 1.4 and 6.1 years after the acute encephalitis, respectively. Antibodies to other microbes were either undetectable in the CSF or the serum/CSF ratios were normal. The clinical sequelae in about half of the patients and the signs of intrathecal mumps antibody production are suggestive of a chronic process in the central nervous system after encephalitis associated with mumps virus infection.
Asunto(s)
Anticuerpos Antivirales/líquido cefalorraquídeo , Encefalitis/inmunología , Virus de la Parotiditis/inmunología , Paperas/inmunología , Adulto , Niño , Preescolar , Encefalitis/líquido cefalorraquídeo , Encefalitis/etiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Paperas/líquido cefalorraquídeo , Paperas/complicaciones , Factores de TiempoAsunto(s)
Encefalitis/diagnóstico , Infecciones por Mycoplasma/diagnóstico , Adolescente , Anticuerpos Antibacterianos/análisis , Niño , Preescolar , Pruebas de Fijación del Complemento , Electroencefalografía , Encefalitis/líquido cefalorraquídeo , Encefalitis/complicaciones , Encefalitis/terapia , Femenino , Humanos , Lactante , Masculino , Infecciones por Mycoplasma/líquido cefalorraquídeo , Infecciones por Mycoplasma/complicaciones , Infecciones por Mycoplasma/terapia , Mycoplasma pneumoniae/inmunología , Pronóstico , Punción EspinalAsunto(s)
Encefalitis/etiología , Virus de la Parotiditis/inmunología , Paperas , Adolescente , Adulto , Anticuerpos Antivirales/análisis , Niño , Enfermedad Crónica , Encefalitis/líquido cefalorraquídeo , Encefalitis/microbiología , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Paperas/microbiología , Replicación ViralRESUMEN
Four hundred five children from the Helsinki area who were 1 month to 16 years old were treated for acute encephalitis at the Children's Hospital, University of Helsinki, from January 1968 through December 1987. Encephalitis occurred most commonly in children 1 to 1.9 years of age, among whom the incidence was 16.7 per 100,000 child-years. The incidence remained quite high until the age of 10 years, and then gradually declined to 1.0 per 100,000 child-years at the age of 15 years. Since 1983, when mumps, measles, and rubella vaccination eradicated the encephalitides associated with these microbes, the major associated agents have been varicella-zoster, Mycoplasma pneumoniae, and respiratory and enteroviruses. In infants younger than 1 year of age, the major agents were enteroviruses, herpes simplex virus, and the group of "others," whereas in older children, respiratory viruses and Mycoplasma pneumoniae, as well as varicella-zoster virus, dominated. In children aged 1 to 11 months, the causal agent could not be identified in one-half of all cases, whereas in children who were at least 10 years old, the etiology remained unknown in only one-fourth of cases. Male dominance was most evident in the 4- to 9-year age group. The difference in etiology between males and females was significant (p = 0.02); mumps and varicella were more common in boys, and adenovirus and Mycoplasma pneumoniae were more common in girls. The overall male-to-female ratio was 1.4:1. Characteristic seasonal variation occurred in encephalitides associated with mumps, measles, and entero- and respiratory viruses.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Encefalitis/epidemiología , Enfermedad Aguda , Adolescente , Niño , Preescolar , Encefalitis/microbiología , Femenino , Finlandia/epidemiología , Encuestas Epidemiológicas , Humanos , Incidencia , Lactante , Masculino , Estaciones del AñoRESUMEN
Percutaneous absorption of hydrocortisone was measured by a four-hour absorption test in 16 children during and after the acute phase of dermatitis. In the acute phase, after the application of 1% hydrocortisone cream the increment in plasma cortisol ranged from 47 to 961 nmol per liter (median 248 nmol/L). After the acute phase the increment was significantly (P less than 0.01) lower: range 18 to 241 nmol per liter (median 95 nmol/L). In addition to local effect, topical hydrocortisone therapy of childhood dermatitis is accompanied by a systemic effect that may be pronounced in the acute phase of disease. Convalescence is connected with a diminished systemic effect due to the restoration of the skin barrier to hydrocortisone.