RESUMEN
BACKGROUND: In resource-rich settings, the rate of mother-to-child transmission of human immunodeficiency virus (HIV) has dramatically decreased by virtue of a combination of preventive strategies during the last two decades. CASE PRESENTATION: We present a case of progressive developmental milestone loss in a toddler with previously unknown congenitally acquired human immunodeficiency virus (HIV) infection, complicated by an Epstein-Barr virus (EBV) coinfection. CONCLUSION: Our report underscores the differential diagnosis between HIV encephalopathy and EBV encephalitis and the vertical transmission of the HIV infection, which constitutes an alarming issue in terms of public health.
Asunto(s)
Encefalitis/diagnóstico , Encefalitis/virología , Infecciones por Virus de Epstein-Barr/patología , Infecciones por VIH/patología , Transmisión Vertical de Enfermedad Infecciosa , Antirretrovirales/uso terapéutico , Preescolar , Disartria/patología , Disartria/virología , Encefalitis/patología , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , VIH-1/aislamiento & purificación , Herpesvirus Humano 4/aislamiento & purificación , Humanos , MasculinoRESUMEN
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by JC virus reactivation. Its occurrence is very rare after solid organ transplantation, especially liver transplantation. We report a patient who received liver transplantation due to liver failure resulting from autoimmune hepatitis and advanced PML presenting with aphasia. A 41-year-old female with a history of liver transplantation who received a usual immunosuppression regimen was admitted with a stroke attack resulting in right hemiplegia 2 months after liver transplantation. Surprisingly, she gradually developed dysarthria and left central facial paresis. A brain MRI showed an abnormal multifocal area with a high T2/flair signal in the deep subcortical white matter of the left hemisphere as well as the splenium of the corpus callosum. PCR evaluation of CSF for JCV was positive while other PCR results were negative. A liver transplant recipient receiving immunosuppressive treatment for a long time could develop PML due to JCV reactivation. Only eight cases of JCV infection were reported after liver transplantation by the time of reporting this case. Unfortunately, there is no definite treatment for PML.
Asunto(s)
Hepatitis Autoinmune/inmunología , Virus JC/genética , Leucoencefalopatía Multifocal Progresiva/inmunología , Trasplante de Hígado , Adulto , Afasia/diagnóstico por imagen , Afasia/fisiopatología , Afasia/virología , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/efectos de los fármacos , Corteza Cerebral/patología , Corteza Cerebral/virología , Cuerpo Calloso/diagnóstico por imagen , Cuerpo Calloso/efectos de los fármacos , Cuerpo Calloso/patología , Cuerpo Calloso/virología , Disartria/diagnóstico por imagen , Disartria/fisiopatología , Disartria/virología , Femenino , Hemiplejía/diagnóstico por imagen , Hemiplejía/fisiopatología , Hemiplejía/virología , Hepatitis Autoinmune/patología , Hepatitis Autoinmune/cirugía , Hepatitis Autoinmune/virología , Humanos , Inmunosupresores/administración & dosificación , Virus JC/inmunología , Virus JC/aislamiento & purificación , Leucoencefalopatía Multifocal Progresiva/diagnóstico por imagen , Leucoencefalopatía Multifocal Progresiva/patología , Leucoencefalopatía Multifocal Progresiva/cirugía , Hígado/efectos de los fármacos , Hígado/inmunología , Hígado/patología , Hígado/cirugía , Imagen por Resonancia Magnética , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/virología , Activación Viral/inmunologíaRESUMEN
We report a 19-year-old female presenting with fever, drooling, anarthria, and voluntary facial movement disruption, characteristic of anterior opercular syndrome (AOS). Serological examination revealed Epstein-Barr virus (EBV) infection following acute encephalitis with severe ataxia. A single-photon emission computerized tomography (SPECT) examination indicated hypoperfusion in the left perisylvian region, bilateral thalamus, occipital lobe, and cerebellum. This is the first report of AOS related to EBV encephalitis. SPECT was a useful method for detecting the damaged region of the operculum. In addition, AOS is a clinically distinct entity that may help us understand the mechanisms of language circuits within the operculum.
Asunto(s)
Encéfalo/virología , Trastornos de Deglución/virología , Disartria/virología , Infecciones por Virus de Epstein-Barr/complicaciones , Parálisis Facial/virología , Herpesvirus Humano 4 , Femenino , Humanos , Adulto JovenRESUMEN
Poliovirus (PV), a member of the Enterovirus genus, is the etiological agent of poliomyelitis. A study carried out between 2013-2014 on 30 serum samples from acute flaccid paralysis (AFP) cases, showed a protective antibody level of 90% against poliovirus Sabin strains type 1 and type 2 and of 88% against type 3. No PV strains were isolated from 2009 to 2015 in Romania. Maintaining a high vaccine coverage level against polio is mandatory until global polio eradication, especially as the risk of polio importation remains elevated in Romania.
Asunto(s)
Disartria/etiología , Parálisis/etiología , Poliomielitis/virología , Vacunas contra Poliovirus/efectos adversos , Poliovirus/inmunología , Enfermedad Aguda/epidemiología , Niño , Preescolar , Disartria/epidemiología , Disartria/virología , Femenino , Humanos , Lactante , Masculino , Parálisis/epidemiología , Parálisis/virología , Poliomielitis/epidemiología , Poliovirus/genética , Vacunas contra Poliovirus/administración & dosificación , Rumanía/epidemiologíaRESUMEN
Chikungunya is an arthropod born acute febrile arbo viral illness characterized by acute severe polyarthralgia. During last few years there has been scattered out breaks with associated neurological complications in India. Here we report a case of post chikungunya reversible demyelinating encephalitis who presented with vertigo, dysarthria and ataxia. There was complete clinical as well as radiological improvement with steroids.