Enteroviruses at a tertiary care center in Saudi Arabia, 1989-1995

Enteroviruses [EV[s]] are among the most common viral pathogens affecting humans. Enterovirus [EV] infections occur worldwide in temperate climates with a marked summer/fall season and have a high year-round incidence in tropical and subtropical areas. In Saudi Arabia, the epidemiology of enteroviruses is unknown. Of the clinical specimens submitted for diagnosis during a six-year period [1989-1995] at King Faisal Specialist Hospital and Research Centre [KFSH and RC] in Riyadh, a variety of disease were associated with the isolation of enteroviruses. Among the disease were herpangina, sepias-like illness, hand-foot-and-mouth syndrome,laryngotracheitis [croup], aseptic meningitis, pneumonia,and gastrointestinal illness. During the six-year study, a variety of enteroviruses were isolated. Although epidemics were seen in mid-winter and early spring. EV which may cause sporadic disease were isolated in each of the 12 months. Health care providers must become aware of the epidemic potential not only in mid-winter and early spring, but also throughout the year, as this will aid in the diagnosis and management of this illness

Aislamiento de virus coxsakie B-5 en un caso fatal de meningoencefalitis / Isolation of coxsakie B-5 virus in a meningoencephalitis fatal case

A 9 month old boy was admitted to the hospital with the diagnosis of meningoencephalitis 15 days after having a clinically diagnosed chickenpox. Lumbar puncture showed clear CSF with 0.23 g/l of proteins, 57 mg/dl of glucpse, 30 red cells/mm3 and 5 leukocytes/mm3. Blood count showed a packed red cell volume of 22 percent, a hemoglobin of 7 g/dl, 14800 leukocytes with 1 percent eosinophils, 5 percent band and 39 percent segmented neutrophils, 50 percent lymphocytes and 5 percent monocytes and a decreased platelet count. On the fourth hospitalization day, the patient had vomiting, irritability and stiff neck. A new lumbar puncture showed a clear CSF that differed from the former only on the glucose level that increased to 102 mg/dl. The patient died and the necropsy showed a congestive and enlarged brain and congestive meninges infiltrated with lymphocytes. There was lymphoid follicle hyperplasia in the small bowel and enlarged mesenteric lymph nodes. Samples of brain, brain stem, spinal cord and tools were sent for virological study. A coxsakie B-5 virus was isolated from the spinal cord sample

Brote epidémico de meningitis aséptica: experiencias en un hospital infantil privado / Epidemic of aseptic meningitis experience of private hospital

Se informa acerca de las experiencias obtenidas en 193 niños con meningitis aséptica, estudiados durante un brote epidémico registrado entre febrero y julio de 1992. Los cultivos de líquido cefalorraquídeo hechos en el Instituto de Referencia Epidemiológica permitieron identificar al virus Echo 30 como un agente a la meningitis en 48 niños

Role of coxsackie B viruses in acute myocarditis in Egyptian children

This study comprised 40 children, aged 1-15 years, suffering from acute myocarditis and admitted to the New Children's Hospital, Cairo University. In addition to clinical and radiological assessment, laboratory tests including ASOT, detection of C-reactive protein and ESR were performed. This confirmed the diagnosis of 28 cases as acute rheumatic myocarditis. Paired sera from the remaining 12 cases, preliminarily diagnosed as viral myocarditis, were assessed for rising titre of complement-fixing antibodies against Coxsackie [B] virus. Two cases had a four-fold increase. Thus 16.6% of suspected viral cases [5% of total acute myocarditis cases] were diagnosed as due to Coxsackie [B] virus infection. This points to a possible role for this virus in acute myocarditis when a rheumatic aetiology has been excluded

Ultrastructural study of cell injury induced by coxsackievirus B3 in pancreatic and cardiac tissues

Con fines de una mejor caracterización de la injuria celular provocada por el coxsackievirus B3 en páncreas y corazón, ratones Balb/C ya destetados fueron intraperitonealmente inoculados con una variante miocardítica de ese serotipo viral. A nivel ultraestructural, las células pancráticas acinosas mostraron evidente distorsión, evidenciada por acentuada pérdida de organelas y de gránulos de zimógeno, así como apreciable dilatación del retículo endoplásmico granuloso. En cuanto a las células cardíacas, las alteraciones citoesqueléticas fueron severas, llegando a incluir colapso de miofibrilas con disminuición de su número e irregularidad en su disposición. Además, los cardiomiocitos exhibieron cromatina de distribución irregular y mitocondrias de tamaño agranado. A la vez de los focos necróticos tendían a desaparecer, el número de fibroblastos aumentaba en forma coincidente a la progresiva cicatrización de la lesión. Los cambios ultraestructurales observados en páncreas y corazón fueron concomitantes en consecuencia que el daño celular era atribuíble a la acción directa del virus

Miocarditis aguda viral. Presentación de un caso clínico / Virological myocarditis acute. Report of a clinic case

La miocarditis aguda viral es una entidad especialmente de jóvenes caracterizada por fiebre, precordialgia, disnea y palpitaciones, puede evolucionar hacia una cardiomiopatía dilatada y ocasionalmente a la muerte. Se presenta el caso de un paciente de 19 años, que ingresó por fiebre, disnea, tos, expectación hemoptoica, precordialgia, edema miembros inferiores y diarrea, precedidas de proceso gripal. Se realiza EGC, Rx. toráx, ecocardiograma, estudio virológico e inmunológico, cateterismo cardíaco, biopsia endomiocárdica. Se destaca la importancia de ésta para el seguimiento y pronóstico en estos pacientes