ABSTRACT
BACKGROUND: The current outbreak of COVID-19 has spread rapidly all over the world. Respiratory droplets and contaction with infected patients are the two major transmission routes. However, the value of tear virus nucleic acid is still not clear. We dynamic detected the SARS-CoV-2 in eye sample of one COVID-19 patient with obstruction of common lacrimal ducts. METHODS: Besides the routine examination, nasopharyngeal and eye swab were continuously measured by polymerase chain reaction assay and next-generation sequencing (NGS). Gene detection was performed for drug use guidance, and flow cytometry was performed to analyse the lymphocyte subsets. RESULTS: Nasopharyngeal swabs were positive for 22 days, but eye swabs were still continuously positive for 2 weeks after nasopharyngeal swabs turned negative. The low level of lymphocyte and the high level IL-6 lasted for almost 4 weeks, then became near normal. Next-generation sequencing (NGS) confirmed the existing of SARS-CoV-2, HSV1 and HHV6B virus nucleic acid. The gene detection for drug use guidance showed the genetic locus ABCB1 (3435T>C) rs1045642 belonged to type CC and it mean the efficiency of lopinavir-ritonavir would be significantly decreased. The flow cytometry of lymphocyte subsets showed PD-1+ CD95+ cells was accounting for 94.8% in CD3+ CD8+ T subset and for 94.8% in CD3+ TCRγδ+ T subset. CONCLUSIONS: As obstruction of common lacrimal duct, positively detection in one eye for 2 weeks more after nasopharyngeal swab became negative. More eye swabs should be collected from COVID-19 patients, especially from those immunocompromised, those with eye symptoms and those had a history of ocular diseases.
Subject(s)
COVID-19/diagnosis , Conjunctiva/virology , Eye Infections, Viral/diagnosis , Herpesvirus 1, Human/isolation & purification , Herpesvirus 6, Human/isolation & purification , Lacrimal Duct Obstruction/diagnosis , SARS-CoV-2/isolation & purification , Tears/virology , Aged , Anti-Bacterial Agents/therapeutic use , COVID-19/virology , Conjunctivitis, Viral/diagnosis , Drug Therapy, Combination , Eye Infections, Viral/drug therapy , Eye Infections, Viral/virology , Flow Cytometry , HIV Protease Inhibitors/therapeutic use , Herpes Simplex/diagnosis , Herpes Simplex/drug therapy , Herpes Simplex/virology , Herpesvirus 1, Human/genetics , Herpesvirus 6, Human/genetics , High-Throughput Nucleotide Sequencing , Humans , Lacrimal Duct Obstruction/drug therapy , Lacrimal Duct Obstruction/virology , Lopinavir/therapeutic use , Male , Medicine, Chinese Traditional , Moxifloxacin/therapeutic use , Nasopharynx/virology , Nucleic Acids/genetics , Polymerase Chain Reaction , RNA, Viral/genetics , Ritonavir/therapeutic use , Roseolovirus Infections/diagnosis , Roseolovirus Infections/drug therapy , Roseolovirus Infections/virology , SARS-CoV-2/genetics , COVID-19 Drug TreatmentABSTRACT
The aim of this study was to evaluate the effect of ganciclovir on human herpesvirus-6 (HHV)-6. Forty allogeneic stem cell transplant recipients were prospectively studied by repeated sampling of the saliva. The saliva samples were assayed for HHV-6 by quantitative polymerase chain reaction. HHV-6 was detected in 33 patients. Ganciclovir was given as preemptive therapy for cytomegalovirus infection during 15 episodes that were compared to 18 episodes without any concomitant antiviral therapy. The mean HHV-6 load decreased 0.49 (s.e. 0.31) log(10)/week in patients receiving ganciclovir whereas it increased 0.15 (s.e. 0.17) log(10)/week in episodes without antiviral therapy (P=0.04). We conclude that ganciclovir can decrease the HHV-6 viral load in saliva.
Subject(s)
Ganciclovir/therapeutic use , Herpesvirus 6, Human/isolation & purification , Saliva/virology , Stem Cell Transplantation , Cytomegalovirus/genetics , Cytomegalovirus/isolation & purification , Cytomegalovirus Infections/prevention & control , Ganciclovir/pharmacology , Herpesvirus 6, Human/drug effects , Humans , Microbial Sensitivity Tests , Polymerase Chain Reaction , Virus SheddingABSTRACT
In our all patients, the antibodies to HHV-6 and -7 were positive before BMT. HHV -6 and -7 DNA were sometimes detected after BMT, and HHV-6 infection after BMT caused fever, interstitial peumonitis, diarrhea, and myelosuppression. However, HHV -7 didn't induce any clinical symptoms. For the diagnosis of the HHV-6 or -7 infection, we used the virus isolation, semiquantitative PCR, and 4-hold elevation of the antibodies to HHV-6 or -7. Ganciclovir, foscarnet, high dose gamma-globulin and high dose acyclovir were useful for the treatment of HHV-6 infection after BMT. HHV-6 is an important agent for the fever of unknown origin, interstitial peumonitis, diarrhea, and myelosuppression after BMT.
Subject(s)
Bone Marrow Transplantation/adverse effects , Herpesviridae Infections/diagnosis , Herpesvirus 6, Human , Herpesvirus 7, Human , Acyclovir/therapeutic use , Antibodies, Viral/analysis , Antiviral Agents/therapeutic use , Foscarnet/therapeutic use , Ganciclovir/therapeutic use , Herpesviridae Infections/drug therapy , Herpesviridae Infections/virology , Herpesvirus 6, Human/immunology , Herpesvirus 6, Human/isolation & purification , Herpesvirus 7, Human/immunology , Herpesvirus 7, Human/isolation & purification , Humans , Immunocompromised Host , Polymerase Chain Reaction , gamma-Globulins/administration & dosageABSTRACT
The neuroradiologic findings of the brain lesions in eight infants with exanthema subitum were normal in three, suspected vascular lesions in two, and symmetric thalamic lesions with or without diffuse brain edema in the other three. In addition, diffuse brain edema or focal cerebral lesions were observed in 13 previously reported Japanese infants. These findings suggest that the pathogeneses of the brain lesions related to exanthema subitum are variable.