ABSTRACT
Abstract Objectives To review the diagnostic criteria for encephalitis and encephalopathy of presumed infectious etiology, as well as the diagnostic workup for viral encephalitis and its treatment approaches. The authors also intended to summarize relevant information on specific viruses frequently found in Brazil. Source of data Literature search on Pubmed/MEDLINE using the following keywords: "viral", "encephalitis", "child", or "adolescents", filtering for articles on humans and in English. Summary of data Viral encephalitis is the most common cause of encephalitis and is responsible for high rates of morbidity, permanent neurologic sequelae, and according to the virus, may have high mortality rates. The most common etiologies are herpesviruses 1 and 2 (HSV-1 and HSV-2), non-polio enterovirus, and arboviruses (in Brazil, dengue, Zika, and chikungunya). Other relevant etiologies are seasonal influenza, cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and the re-emergent measles. Conclusion Clinical data, laboratory results, and neuroimaging findings support the diagnosis of encephalitis and the specific viral etiology. To increase the likelihood of etiologic confirmation, it is important to know the best approach to collecting samples and to choose the best identification technique for each virus. The differential diagnosis of viral encephalitis includes other infections and immune-mediated inflammatory central nervous system disorders.
Resumo Objetivos Revisar os critérios diagnósticos para encefalite e encefalopatia de etiologia infecciosa presumida, assim como a investigação diagnóstica para encefalite viral e suas abordagens terapêuticas. Além disso, pretendemos resumir tópicos relevantes sobre os vírus específicos frequentemente encontrados no Brasil. Fonte de dados Pesquisa bibliográfica feita nos bancos de dados Pubmed/Medline utilizando as seguintes palavras-chave: "viral", "encephalitis", "child" ou "adolescents", limitando os artigos a estudos em humanos e escritos em inglês. Resumo dos dados A encefalite viral é a causa mais comum de encefalite e é responsável por altas taxas de morbidade, sequelas neurológicas permanentes e, de acordo com o vírus, altas taxas de mortalidade. As etiologias mais comuns são herpes vírus 1 e 2 (HSV-1 e HSV-2), enterovírus não pólio e arbovírus (no Brasil, Dengue, Zika e Chikungunya). Outras etiologias relevantes são a influenza sazonal, o citomegalovírus (CMV), o vírus Epstein-Barr (EBV), o herpes vírus humano 6 (HHV-6) e o sarampo reemergente. Conclusão Dados clínicos, resultados laboratoriais e de neuroimagem apoiam o diagnóstico de encefalite e a etiologia viral específica. Para aumentar a probabilidade de confirmação etiológica, é importante conhecer a melhor abordagem para coletar amostras e escolher a melhor técnica de identificação para cada vírus. O diagnóstico diferencial de encefalite viral inclui outras infecções e distúrbios inflamatórios do sistema nervoso central imunomediados.
Subject(s)
Humans , Child , Adolescent , Encephalitis, Viral/diagnosis , Encephalitis, Viral/therapy , Brazil , Herpesvirus 6, Human , Herpesvirus 4, Human , Cytomegalovirus , Zika Virus , Zika Virus InfectionABSTRACT
OBJECTIVES: To review the diagnostic criteria for encephalitis and encephalopathy of presumed infectious etiology, as well as the diagnostic workup for viral encephalitis and its treatment approaches. The authors also intended to summarize relevant information on specific viruses frequently found in Brazil. SOURCE OF DATA: Literature search on Pubmed/MEDLINE using the following keywords: "viral", "encephalitis", "child", or "adolescents", filtering for articles on humans and in English. SUMMARY OF DATA: Viral encephalitis is the most common cause of encephalitis and is responsible for high rates of morbidity, permanent neurologic sequelae, and according to the virus, may have high mortality rates. The most common etiologies are herpesviruses 1 and 2 (HSV-1 and HSV-2), non-polio enterovirus, and arboviruses (in Brazil, dengue, Zika, and chikungunya). Other relevant etiologies are seasonal influenza, cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and the re-emergent measles. CONCLUSION: Clinical data, laboratory results, and neuroimaging findings support the diagnosis of encephalitis and the specific viral etiology. To increase the likelihood of etiologic confirmation, it is important to know the best approach to collecting samples and to choose the best identification technique for each virus. The differential diagnosis of viral encephalitis includes other infections and immune-mediated inflammatory central nervous system disorders.
Subject(s)
Encephalitis, Viral , Adolescent , Brazil , Child , Cytomegalovirus , Encephalitis, Viral/diagnosis , Encephalitis, Viral/therapy , Herpesvirus 4, Human , Herpesvirus 6, Human , Humans , Zika Virus , Zika Virus InfectionABSTRACT
OBJECTIVE: To characterize the full spectrum, relative frequency, and prognosis of the neurologic manifestations in Zika virus (ZIKV) postnatal infection. METHODS: We conducted an observational study in consecutive ZIKV-infected patients presenting with neurologic manifestations during the French West Indies 2016 outbreak. RESULTS: Eighty-seven patients, including 6 children, were enrolled. Ninety-five percent of all cases required hospitalization. Guillain-Barré syndrome was the most frequent manifestation (46.0%) followed by encephalitis or encephalomyelitis (20.7%), isolated single or multiple cranial nerve palsies (9.2%), other peripheral manifestations (6.9%), and stroke (1.1%). Fourteen patients (16.1%), including one child, developed a mixed disorder involving both the central and peripheral nervous system. Mechanical ventilation was required in 21 cases, all of whom had ZIKV RNA in at least one biological fluid. Two adult patients died due to neuroZika. Clinical follow-up (median 14 months; interquartile range, 13-17 months) was available for 76 patients. Residual disability (modified Rankin Scale score ≥2) was identified in 19 (25.0%) patients; in 6 cases (7.9%), disability was severe (modified Rankin Scale score ≥4). Among patients with ZIKV RNA detected in one biological fluid, the risk of residual disability or death was higher (odds ratio 9.19; confidence interval 1.12-75.22; p = 0.039). CONCLUSIONS: NeuroZika spectrum represents a heterogeneous group of clinical neurologic manifestations. During an outbreak, clinicians should consider neuroZika in patients presenting with cranial nerve palsies and a mixed neurologic disorder. Long-term sequelae are frequent in NeuroZika. ZIKV reverse-transcription PCR status at admission can inform prognosis and should therefore be taken into consideration in the management of hospitalized patients.
Subject(s)
Cranial Nerve Diseases/therapy , Encephalitis, Viral/therapy , Encephalomyelitis/therapy , Guillain-Barre Syndrome/physiopathology , Zika Virus Infection/therapy , Adolescent , Adult , Aged , Child , Child, Preschool , Cranial Nerve Diseases/metabolism , Cranial Nerve Diseases/physiopathology , Encephalitis, Viral/metabolism , Encephalitis, Viral/physiopathology , Encephalomyelitis/metabolism , Encephalomyelitis/physiopathology , Female , Hospitalization , Humans , Infant , Male , Middle Aged , Prognosis , RNA, Viral/blood , RNA, Viral/cerebrospinal fluid , RNA, Viral/urine , Respiration, Artificial , Treatment Outcome , West Indies , Zika Virus Infection/metabolism , Zika Virus Infection/physiopathologyABSTRACT
Many RNA virus CNS infections cause neurological disease. Because Piry virus has a limited human pathogenicity and exercise reduces activation of microglia in aged mice, possible influences of environment and aging on microglial morphology and behavior in mice sublethal encephalitis were investigated. Female albino Swiss mice were raised either in standard (S) or in enriched (EE) cages from age 2 to 6 months (young - Y), or from 2 to 16 months (aged - A). After behavioral tests, mice nostrils were instilled with Piry-virus-infected or with normal brain homogenates. Brain sections were immunolabeled for virus antigens or microglia at 8 days post-infection (dpi), when behavioral changes became apparent, and at 20 and 40 dpi, after additional behavioral testing. Young infected mice from standard (SYPy) and enriched (EYPy) groups showed similar transient impairment in burrowing activity and olfactory discrimination, whereas aged infected mice from both environments (EAPy, SAPy) showed permanent reduction in both tasks. The beneficial effects of an enriched environment were smaller in aged than in young mice. Six-hundred and forty microglial cells, 80 from each group were reconstructed. An unbiased, stereological sampling approach and multivariate statistical analysis were used to search for microglial morphological families. This procedure allowed distinguishing between microglial morphology of infected and control subjects. More severe virus-associated microglial changes were observed in young than in aged mice, and EYPy seem to recover microglial homeostatic morphology earlier than SYPy . Because Piry-virus encephalitis outcomes were more severe in aged mice, it is suggested that the reduced inflammatory response in those individuals may aggravate encephalitis outcomes.
Subject(s)
Aging , Brain/pathology , Encephalitis, Viral/pathology , Encephalitis, Viral/therapy , Environment , Microglia/pathology , Analysis of Variance , Animals , CD3 Complex/metabolism , Calcium-Binding Proteins/metabolism , Disease Models, Animal , Encephalitis, Viral/physiopathology , Exploratory Behavior , Female , Imaging, Three-Dimensional , Memory/physiology , Mice , Microfilament Proteins/metabolism , Rhabdoviridae/pathogenicity , Smell/physiology , Time FactorsABSTRACT
While systemic viral infections are exceptionally common, symptomatic viral infections of the brain parenchyma itself are very rare, but a serious neurologic condition. It is estimated that viral encephalitis occurs at a rate of 1.4 cases per 100.000 inhabitants. Geography is a major determinant of encephalitis caused by vector-borne pathogens. A diagnosis of viral encephalitis could be a challenge to the clinician, since almost 70% of viral encephalitis cases are left without an etiologic agent identified. In this review, the most common viral encephalitis will be discussed, with focus on ecology, diagnosis, and clinical management.
Subject(s)
Encephalitis, Viral/diagnosis , Encephalitis, Viral/virology , Diagnosis, Differential , Encephalitis, Viral/therapy , HumansABSTRACT
Viral encephalitis is a severe illness that produces inflammation of the brain. CNS viral infections frequently occur as a complication of systemic viral infections. Over 100 viruses are implicated as causative agents, including herpes simplex virus type I which is the most common agent implied in non-epidemic encephalitis in all population groups in the world, and is responsible for the most severe cases in all ages. Many viruses, for which there are vaccines, may also cause encephalitis: measles, mumps, polio, rabies, rubella, and chickenpox. The virus causes an inflammation of the brain tissue, which may progress to destruction of nerve cells, cause bleeding and brain damage, leading to severe encephalitis, such as hemorrhagic or necrotizing encephalitis, with a worse prognosis, producing serious sequelae or death. The clinical evolution includes the presence of headache, fever and altered consciousness rapidly progressive. The outcome of viral encephalitis is variable, some cases are mild, with full recovery, but there are serious cases that can cause severe sequel in the brain. To diagnose this illness as soon as possible is essential, through laboratory tests (biochemistry, virus PCR, culture) and neuroimaging (CT, MRI) and above all, the establishment of early treatment to prevent the development of the process and possible complications. The prognosis worsens if the initiation of treatment is delayed.
Subject(s)
Encephalitis, Viral/diagnosis , Encephalitis, Viral/therapy , Antiviral Agents/therapeutic use , Child , Diagnosis, Differential , Encephalitis, Viral/virology , Humans , Polymerase Chain Reaction , PrognosisABSTRACT
While systemic viral infections are exceptionally common, symptomatic viral infections of the brain parenchyma itself are very rare, but a serious neurologic condition. It is estimated that viral encephalitis occurs at a rate of 1.4 cases per 100.000 inhabitants. Geography is a major determinant of encephalitis caused by vector-borne pathogens. A diagnosis of viral encephalitis could be a challenge to the clinician, since almost 70% of viral encephalitis cases are left without an etiologic agent identified. In this review, the most common viral encephalitis will be discussed, with focus on ecology, diagnosis, and clinical management.
Embora as infecções virais sistêmicas sejam muito comuns, as infecções virais sintomáticas do parênquima cerebral são raras, mas potencialmente graves. Estima-se que a encefalite viral ocorra em 1,4 casos por 100.000 habitantes anualmente. A localização geográfica é um fator determinante a ser levado em consideração frente aos patógenos transmitidos por vetores. O diagnóstico clínico das encefalites virais pode ser um desafio para o clínico, visto que quase 70% dos casos de encefalite viral ficam sem a identificação do agente viral. Nesta revisão, as encefalites virais mais comuns serão discutidas, com interesse especial sobre os aspectos da ecologia, do diagnóstico e do seu manejo clínico.
Subject(s)
Humans , Encephalitis, Viral/diagnosis , Encephalitis, Viral/virology , Diagnosis, Differential , Encephalitis, Viral/therapyABSTRACT
Viral encephalitis is a severe illness that produces inflammation of the brain. CNS viral infections frequently occur as a complication of systemic viral infections. Over 100 viruses are implicated as causative agents, including herpes simplex virus type I which is the most common agent implied in non-epidemic encephalitis in all population groups in the world, and is responsible for the most severe cases in all ages. Many viruses, for which there are vaccines, may also cause encephalitis: measles, mumps, polio, rabies, rubella, and chickenpox. The virus causes an inflammation of the brain tissue, which may progress to destruction of nerve cells, cause bleeding and brain damage, leading to severe encephalitis, such as hemorrhagic or necrotizing encephalitis, with a worse prognosis, producing serious sequelae or death. The clinical evolution includes the presence of headache, fever and altered consciousness rapidly progressive. The outcome of viral encephalitis is variable, some cases are mild, with full recovery, but there are serious cases that can cause severe sequel in the brain. To diagnose this illness as soon as possible is essential, through laboratory tests (biochemistry, virus PCR, culture) and neuroimaging (CT, MRI) and above all, the establishment of early treatment to prevent the development of the process and possible complications. The prognosis worsens if the initiation of treatment is delayed.
Subject(s)
Encephalitis, Viral/diagnosis , Encephalitis, Viral/therapy , Antiviral Agents/therapeutic use , Child , Diagnosis, Differential , Encephalitis, Viral/virology , Humans , Polymerase Chain Reaction , PrognosisABSTRACT
Viral encephalitis is a severe illness that produces inflammation of the brain. CNS viral infections frequently occur as a complication of systemic viral infections. Over 100 viruses are implicated as causative agents, including herpes simplex virus type I which is the most common agent implied in non-epidemic encephalitis in all population groups in the world, and is responsible for the most severe cases in all ages. Many viruses, for which there are vaccines, may also cause encephalitis: measles, mumps, polio, rabies, rubella, and chickenpox. The virus causes an inflammation of the brain tissue, which may progress to destruction of nerve cells, cause bleeding and brain damage, leading to severe encephalitis, such as hemorrhagic or necrotizing encephalitis, with a worse prognosis, producing serious sequelae or death. The clinical evolution includes the presence of headache, fever and altered consciousness rapidly progressive. The outcome of viral encephalitis is variable, some cases are mild, with full recovery, but there are serious cases that can cause severe sequel in the brain. To diagnose this illness as soon as possible is essential, through laboratory tests (biochemistry, virus PCR, culture) and neuroimaging (CT, MRI) and above all, the establishment of early treatment to prevent the development of the process and possible complications. The prognosis worsens if the initiation of treatment is delayed.
Subject(s)
Encephalitis, Viral/diagnosis , Encephalitis, Viral/therapy , Antiviral Agents/therapeutic use , Child , Diagnosis, Differential , Encephalitis, Viral/virology , Humans , Prognosis , Polymerase Chain ReactionABSTRACT
The aim is to review the encephalitis in infants and adolescents as well as its etiology, clinical manifestation, epidemiology, physiopathology, diagnostic methods and treatment, and the neuropsyquiatric signs appearing an influenza epidemy. Encephalitis is an inflammation of the central nervous system (CNS) which involves the brain. The clinical manifestations usually are: headache, fever and confusional stage. It could also be manifested as seizures, personality changes, or psiqyiatric symptoms. The clinical manifestations are related to the virus and the cell type affected in the brain. A meningitis or encephalopathy need to be ruled out. It could be present as an epidemic or isolated form, beeing this the most frequent form. It could be produced by a great variety of infections agents including virus, bacterias, fungal and parasitic. Viral causes are herpesvirus, arbovirus, rabies and enterovirus. Bacterias such as Borrelia burgdorferi, Rickettsia and Mycoplasma neumoniae. Some fungal causes are: Coccidioides immitis and Histoplasma capsulatum. More than 100 agents are related to encephalitis. The diagnosis of encephalitis is a challenge for the clinician and its infectious etiology is clear in only 40 to 70% of all cases. The diagnosis of encephalitis can be established with absolute certainty only by the microscopic examination of brain tissue. Epidemiology is related to age of the patients, geographic area, season, weather or the host immune system. Early intervention can reduce the mortality rate and sequels. We describe four patients with encephalitis and neuropsychiatric symptoms during an influenza epidemic.
Subject(s)
Brain Diseases/virology , Encephalitis, Viral/diagnosis , Influenza, Human/diagnosis , Acute Disease , Adolescent , Brain Diseases/diagnosis , Brain Diseases/therapy , Child , Child, Preschool , Diagnosis, Differential , Encephalitis, Viral/physiopathology , Encephalitis, Viral/therapy , Female , Humans , Influenza, Human/physiopathology , Influenza, Human/therapy , Male , PrognosisSubject(s)
Amantadine/therapeutic use , Antiviral Agents/therapeutic use , Deep Sedation , Encephalitis, Viral/drug therapy , Rabies/drug therapy , Ribavirin/therapeutic use , Adolescent , Amantadine/administration & dosage , Animals , Antibodies, Neutralizing/biosynthesis , Antibodies, Neutralizing/immunology , Antibodies, Viral/biosynthesis , Antibodies, Viral/immunology , Antiviral Agents/administration & dosage , Chiroptera/virology , Clinical Protocols , Combined Modality Therapy , Deep Sedation/adverse effects , Electroencephalography/drug effects , Encephalitis, Viral/immunology , Encephalitis, Viral/therapy , Excitatory Amino Acid Antagonists/administration & dosage , Excitatory Amino Acid Antagonists/pharmacology , Excitatory Amino Acid Antagonists/therapeutic use , Female , Humans , Ketamine/administration & dosage , Ketamine/pharmacology , Ketamine/therapeutic use , Midazolam/administration & dosage , Midazolam/pharmacology , Midazolam/therapeutic use , Phenobarbital/administration & dosage , Phenobarbital/pharmacology , Phenobarbital/therapeutic use , Rabies/immunology , Rabies/therapy , Rabies virus/immunology , Ribavirin/administration & dosageABSTRACT
El objetivo fue revisar la encefalitis en niños y adolescentes, su etiología, manifestaciones clínicas, fisiopatología, métodos diagnósticos y tratamiento, enfatizando las manifestaciones neuropsiquiátricas de la encefalitis durante una epidemia de influenza. La encefalitis se considera una inflamación del sistema nervioso central (SNC) que compromete el cerebro. Se manifiesta usualmente por cefaleas, fiebre y trastorno del estado de conciencia. Puede además manifestarse por convulsiones, cambios en la personalidad y manifestaciones obsesivas (síntomas neuropsiquiátricos). Las manifestaciones dependerán del tipo de virus y las células afectadas. La encefalitis puede ser causada por una gran variedad de agentes infecciosos incluyendo virus, bacterias, hongos y parásitos. Causas virales de encefalitis incluyen herpesvirus, arbovirus, rabia y enterovirus. Casos establecidos de bacterias incluyen Borrelia burgdorferi y rickettsia y el Mycoplasma neumoniae, al cual se atribuyen varios casos de encefalitis. Otros agentes como el hongo Coccidioides immitis e Histoplasma capsulatum pueden también generarla. Más de 100 agentes se han asociado a encefalitis. El diagnóstico de encefalitis constituye un reto para el clínico, y su etiología infecciosa usualmente se identifica entre el 40% al 70% de casos. El diagnóstico se hace con absoluta certeza sólo con una biopsia cerebral. La epidemiología depende de ciertos factores como la edad, la localización geográfica, la época del año, las condiciones climáticas y la inmunocompetencia del huésped. El tratamiento temprano puede disminuir el riesgo de muerte y las secuelas. Describimos cuatro pacientes con encefalitis y manifestaciones neuropsiquiátricas durante una epidemia de influenza, con el fin de alertar sobre esta asociación.
The aim is to review the encephalitis in infants and adolescents as well as its etiology, clinical manifestation, epidemiology, physiopathology, diagnostic methods and treatment, and the neuropsyquiatric signs appearing an influenza epidemy. Encephalitis is an inflammation of the central nervous system (CNS) which involves the brain. The clinical manifestations usually are: headache, fever and confusional stage. It could also be manifested as seizures, personality changes, or psiqyiatric symptoms. The clinical manifestations are related to the virus and the cell type affected in the brain. A meningitis or encephalopathy need to be ruled out. It could be present as an epidemic or isolated form, beeing this the most frequent form. It could be produced by a great variety of infections agents including virus, bacterias, fungal and parasitic. Viral causes are herpesvirus, arbovirus, rabies and enterovirus. Bacterias such as Borrelia burgdorferi, Rickettsia and Mycoplasma neumoniae. Some fungal causes are: Coccidioides immitis and Histoplasma capsulatum. More than 100 agents are related to encephalitis. The diagnosis of encephalitis is a challenge for the clinician and its infectious etiology is clear in only 40 to 70% of all cases. The diagnosis of encephalitis can be established with absolute certainty only by the microscopic examination of brain tissue. Epidemiology is related to age of the patients, geographic area, season, weather or the host immune system. Early intervention can reduce the mortality rate and sequels. We describe four patients with encephalitis and neuropsychiatric symptoms during an influenza epidemic.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Brain Diseases/virology , Encephalitis, Viral/diagnosis , Influenza, Human/diagnosis , Acute Disease , Brain Diseases/diagnosis , Brain Diseases/therapy , Diagnosis, Differential , Encephalitis, Viral/physiopathology , Encephalitis, Viral/therapy , Influenza, Human/physiopathology , Influenza, Human/therapy , PrognosisABSTRACT
La encefalitis por Herpes Simple tipo 1 es una enfermedad grave. Su pronóstico depende del diagnóstico y tratamiento precoz. Se analizan cuatro historias clínicas de niños con encefalitis herpética diagnosticada por Reacción en Cadena de la Polimerasa (PCR) en líquido cefalorraquídeo (LCR) entre marzo de 1995 y marzo de 1997. Se trata de tres lactantes y un escolar. Todos presentaron manifestaciones clínicas similares al ingreso: fiebre, depresión neurosíquica (DNS) y convulsiones (parciales o generalizadas). El análisis citoquímico del LCR al ingreso fue normal en tres casos. Los hallazgos tomográficos en la evolución fueron idénticos: infarto fronto témporo parietal. En un sólo caso se valoró el fondo de ojo al inicio. Tres pacientes tuvieron evolución clínica similar: profundización de la DNS, convulsiones y signos locales. Todos quedaron con secuelas, que fueron más graves en los pacientes en los que el tratamiento se instaló tardíamente. Con el objetivo de protocolizar las indicaciones de la búsqueda viral por PCR y de mejorar el pronóstico de estos pacientes se propone un algoritmo de diagnóstico, estudio y tratamiento para esta enfermedad
Subject(s)
Humans , Male , Female , Infant , Encephalitis, Viral/cerebrospinal fluid , Encephalitis, Viral/diagnosis , Encephalitis, Viral/therapy , Herpesviridae Infections/diagnosis , Herpesviridae Infections/drug therapy , Acyclovir/therapeutic use , Clinical Protocols , Polymerase Chain ReactionABSTRACT
La encefalitis por Herpes Simple tipo 1 es una enfermedad grave. Su pronóstico depende del diagnóstico y tratamiento precoz. Se analizan cuatro historias clínicas de niños con encefalitis herpética diagnosticada por Reacción en Cadena de la Polimerasa (PCR) en líquido cefalorraquídeo (LCR) entre marzo de 1995 y marzo de 1997. Se trata de tres lactantes y un escolar. Todos presentaron manifestaciones clínicas similares al ingreso: fiebre, depresión neurosíquica (DNS) y convulsiones (parciales o generalizadas). El análisis citoquímico del LCR al ingreso fue normal en tres casos. Los hallazgos tomográficos en la evolución fueron idénticos: infarto fronto témporo parietal. En un sólo caso se valoró el fondo de ojo al inicio. Tres pacientes tuvieron evolución clínica similar: profundización de la DNS, convulsiones y signos locales. Todos quedaron con secuelas, que fueron más graves en los pacientes en los que el tratamiento se instaló tardíamente. Con el objetivo de protocolizar las indicaciones de la búsqueda viral por PCR y de mejorar el pronóstico de estos pacientes se propone un algoritmo de diagnóstico, estudio y tratamiento para esta enfermedad(AU)
Subject(s)
INFORME DE CASO , Humans , Male , Female , Infant , Child , Herpesviridae Infections/diagnosis , Herpesviridae Infections/drug therapy , Encephalitis, Viral/diagnosis , Encephalitis, Viral/cerebrospinal fluid , Encephalitis, Viral/therapy , Polymerase Chain Reaction , Acyclovir/therapeutic use , Clinical ProtocolsABSTRACT
Severe complicated measles has a high mortality rate and no specific treatment. Ten patients with complicated measles - 9 infants with respiratory failure and a 15 year old boy with encephalitis - received immunotherapy with Non-specific Transfer Factor (NTF). The patients had variable degrees of undernourishment and were severely ill when immunotherapy was started. 8/9 cases with respiratory failure were cured. One died of bronchoaspiration while recovering from the measles. The case with encephalitis showed no neurological sequelae two weeks after receiving the last dose of NTF. Treatment of complicated measles with NTF in these patients seemed very effective and deserves further trial.