Progressive multifocal leukoencephalopathy in an HIV-infected child.

Progressive multifocal leukoencephalopathy is an infection of the immunosuppressed, especially of AIDS, patients. The disease is caused by the JC virus and is exceptionally rare in children. The diagnosis is based on MRI and on the detection of JC virus DNA in the cerebrospinal fluid. Progression is relentless in most cases. The only treatment of proven benefit is restoration of the immune system by highly active antiretroviral therapy. We report the case of a 15S-year-old HIV-infected boy. After several months of fatigue he developed apathy, head tilt, diplopia, motor apraxia and unsteady gait. Physical examination revealed mild cerebellar signs. MRI showed a 30-mm large, non-enhancing, hyper-intense area in the right cerebellar hemisphere and the middle cerebellar peduncle. JC virus DNA was detected in the cerebrospinal fluid. Two weeks later the MRI showed progression. The patient's condition rapidly worsened and he died four months after the onset of the disease. Autopsy revealed widespread lesions of the cerebellar hemispheres and the brainstem. The case presented is peculiar owing to the young age of the patient, the unusual localization and the unifocal nature of the lesion.

Group A rotavirus G type prevalence in two regions of Hungary.

Rotaviruses are a major cause of gastroenteritis in children world-wide. Rotaviruses are antigenically complex, with multiple serotypes (G types). The first longitudinal study of group A rotavirus serotype (G type) distribution in Hungary is reported. Neutralizing monoclonal antibodies specific for G1, G2, G3, and G4 were used in an enzyme immunoassay to determine the antigenic variation of group A rotaviruses in two collections of stool specimens assembled from 1984-1992 in Baranya County, southwest Hungary, and from 1988-1992 at the Central Hospital for Infectious Diseases in Budapest. Ninety-two percent of the 1215 virus-positive samples were typed as follows: G1 (81%), G2 (4%), G3 (1%), G4 (5%), or mixed type (1%). G1 was the predominant type during the entire study period with the exception of the 1988/1989 rotavirus season in Baranya County when G4 predominated. Among G1 strains, different electropherotypes were detected with a shift of the predominant G1 electropherotype(s) each 2 to 3 years. G typing from two longitudinal collections established regional differences within Hungary in the prevalence of rotavirus antigenic types among children with rotavirus-associated diarrhea. These are the first longitudinal rotavirus typing results for Hungary and Central Europe.