ABSTRACT
OBJECTIVES: Encephalitis is a severe neurological syndrome for which herpesvirus and enteroviruses are the most common etiological agents. Arboviruses, a wildly diverse group of pathogens, are also critical epidemiological agents associated with encephalitis. In Brazil, little is known about the causative agents of encephalitis. METHODS: We conducted a hospital surveillance for encephalitis between 2020 and 2022. Molecular (RT-PCR and qPCR) and serological (virus-specific IgM and viral antigens) techniques were performed in cerebrospinal fluid and serum samples obtained from study participants. RESULTS: In the 43 participants evaluated, the etiologic agent or the presence of IgM was detected in 16 (37.2%). Nine (20.9%) cases were positive for chikungunya virus (CHIKV), three (7.0%) for dengue virus, two (4.7%) for human adenovirus, one (2.3%) for varicella-zoster virus, and one (2.3%) for enterovirus. Whole-genome sequencing revealed that the CHIKV identified belongs to the East/Central/South African lineage. CONCLUSION: Herein, CHIKV is a common pathogen identified in encephalitis cases. Our results reinforce previous evidence that chikungunya represents a significant cause of encephalitis during CHIKV outbreaks and epidemics and add to existing information on the epidemiology of encephalitis in Brazil.
Subject(s)
Chikungunya Fever , Chikungunya virus , Humans , Brazil/epidemiology , Chikungunya virus/genetics , Chikungunya virus/isolation & purification , Male , Female , Chikungunya Fever/epidemiology , Chikungunya Fever/virology , Chikungunya Fever/diagnosis , Chikungunya Fever/blood , Adult , Adolescent , Child , Young Adult , Middle Aged , Child, Preschool , Antibodies, Viral/blood , Encephalitis, Viral/epidemiology , Encephalitis, Viral/virology , Encephalitis, Viral/diagnosis , Immunoglobulin M/blood , Aged , Dengue Virus/genetics , Dengue Virus/isolation & purification , Infant , Phylogeny , Herpesvirus 3, Human/genetics , Herpesvirus 3, Human/isolation & purification , Enterovirus/isolation & purification , Enterovirus/genetics , Whole Genome SequencingABSTRACT
Praziquantel (PZQ) is a medication used to treat several parasitic infections, including human schistosomiasis. Although this drug commonly causes transient adverse effects, severe hypersensitivity is rare, and only eight cases have been reported worldwide. Herein we report a case of a 13-year-old Brazilian female who developed anaphylaxis, a severe hypersensitive reaction, after taking praziquantel to treat Schistosoma mansoni infection. During a mass drug administration event in a socially vulnerable endemic area of Bahia (Brazil), after taking 60 mg/kg of praziquantel the patient developed rash and generalized edema an hour later, evolving to somnolence and hypotension. Following the anaphylactic episode, she received adequate treatment and recovered approximately 1 day later. Although praziquantel is considered safe, health professionals should be aware of potential life-threatening adverse events.