ABSTRACT
Enteroviruses (EVs) and human herpesviruses (HHVs) are involved frequently in acute neurological disorders of viral etiology. This study aimed to investigate the incidence of herpes simplex virus types-1 (HSV-1) and 2 (HSV-2), varicella-zoster virus (VZV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6) and human enteroviruses (EVs) in cerebrospinal fluid (CSF) samples of Tunisian immunocompetent patients with neuromeningeal disorders. The patients had been hospitalized at the Fattouma Bourguiba University Hospital (Monastir, Tunisia) between September 2007 and June 2009. At least one viral genome was detected in 58 (46%) out of 126 CSF samples collected. Enterovirus was detected in 31 of the positive samples (53.4%), CMV in 20 (34.5%), HSV-1 in 3 (5.2%), HSV-2 in 6 (10.3%), VZV in 4 (6.9%), HHV-6 in 2 (3.4%). More than one viral genome was detected in seven CSF samples, including CMV DNA in six of the samples. The high frequency of enteroviral infections in aseptic meningitis was confirmed. The detection of CMV DNA only suggests a direct role of this virus in the etiology of acute neuromeningeal disorder.
Subject(s)
Enterovirus Infections/cerebrospinal fluid , Enterovirus/isolation & purification , Herpesviridae Infections/cerebrospinal fluid , Herpesviridae/isolation & purification , Meningitis/cerebrospinal fluid , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Cytomegalovirus/isolation & purification , DNA, Viral/cerebrospinal fluid , Enterovirus/immunology , Female , Herpesviridae/immunology , Herpesviridae Infections/epidemiology , Herpesviridae Infections/virology , Herpesvirus 1, Human/isolation & purification , Herpesvirus 2, Human/isolation & purification , Herpesvirus 3, Human/isolation & purification , Herpesvirus 6, Human/isolation & purification , Humans , Infant , Male , Meninges/pathology , Meninges/virology , Meningitis/pathology , Meningitis/virology , Middle Aged , RNA, Viral/cerebrospinal fluid , Tunisia/epidemiology , Young AdultABSTRACT
We report a 62 year-old-man with facial cellulitis revealing choreo-acanthocytosis (ChAc). He showed chorea that started 20 years ago. The orofacial dyskinisia with tongue and cheek biting resulted in facial cellulitis. The peripheral blood smear revealed acanthocytosis of 25%. The overall of chorea, orofacial dyskinetic disorder, peripheral neuropathy, disturbed behavior, acanthocytosis and the atrophy of caudate nuclei was suggestive of a diagnosis of ChAc. To our knowledge no similar cases of facial cellulitis revealing choreo-acanthocytosis (ChAc) were found in a review of the literature.