[Analysis of clinical features of herpes encephalitis].

Herpes encephalitis makes up more than 20% of all viral encephalitises in countries with moderate climate. Over the period of 1971-2008, 112 inpatients with herpes encephalitis have been examined and treated. Outcomes were as follows: 90 (80%) patients recovered and 22 (20%) patients died. The diagnostic criteria were the relation with herpes simplex virus type I (HSV-1) by immunological and clinical data in the presence of clinical symptoms of viral encephalitis for recovered patients and clinical symptoms of acute encephalitis, morphological foci of necrosis in the brain, relation with HSV, the absence of other alternative diagnosis for dead patients. Based on the analysis of 112 patients, the authors present clinical symptoms of herpes encephalitis. The presentation is supported by 2 case reports.

[Paralytic poliomyelitis in Russian Federation in 1998-2005].

From 1998 through 2005 3,294 cases of acute flaccid paralysis (AFP) including 93 cases with clinical picture of poliomyelitis were registered in Russian Federation. From the latter cases 91 were classified as vaccine-associated paralytic poliomyelitis (VAPP): 66 were VAPP cases in oral poliomyelitis vaccine (OPV) recipients and 25--VAPP cases in contacts. VAPP rate was 1 case per 1.6 million of distributed OPV doses, 1 case per 2.2 million doses for OPV recipients, and 1 case per 186,000 doses for recipients of 1st OPV dose in children aged < 1 year. Majority of VAPP cases in recipients occurred after 1st dose (89.4%) and in contacts--in non-vaccinated children (76%). Mean interval between OPV administration and onset of VAPP in recipients was 21 days. Children aged < 1 year were predominant among VAPP cases (92.4% among recipient VAPP cases, and 80% among contact VAPP cases). Majority of the patients had unfavorable health status including defects of immunity. Most of poliovirus strains isolated from VAPP cases belonged to type 3 (52.9%) whereas to type 2 and 1--29.8% and 17.4% of strains respectively. All VAPP cases were associated with vaccine-derived polioviruses. A highly diverged poliovirus type 1 (2.65% of nucleotide substitutions in VP1 region) was isolated from patient with contact VAPP. Formation of poliovirus-neutralizing serum antibodies in children with VAPP including persons with immunodeficiency reflects the ability of the organism to produce specific antiviral immune response.

[Nervous system involvement in hemorrhagic fever with renal syndrome].

The authors of the article describe two cases of hemorrhagic fever with renal syndrome (HFRS) with prevalence of signs of nervous system involvement. The first case was a 40-year-old woman with moderate HFRS, who developed Guillain-Barre syndrome of axonal-demyelinating polyneuropathy. An important observation was the absence of hemorrhagic or renal syndrome; combined therapy including plasmapheresis was successful. The second case demonstrated polymorphism of HFRS clinical manifestations with prevalence of neurological symptoms, which consisted in encephalopathy and no renal failure signs; hemorrhagic syndrome was moderate. In both cases the diagnosis was confirmed by elevated titer of antibodies to HFRS virus, belonging to the group of hantaviruses.

[What surgeon must know about rabies and its treatment]. / Chto dolzhen znat' khirurg o beshenstve i ego lechenii.

From 1991 to 2002 10 patients with rabies were treated, all the patients died. Epidemiology, clinical picture, specific symptoms are described, rarity of this severe disease is noted. The necessity of urgent preventive vaccination immediately after bites is emphasized.

Acute disseminated encephalomyelitis in children: clinical features and HLA-DR linkage.

This study includes 90 children (41 female and 49 male) in the age range of 2-16 years with acute disseminated encephalomyelitis (ADEM). Thirty-three patients developed ADEM following rubella infection, 26 children following varicella infection, 20 suspected viral aetiology ADEM and 11 multiphasic disseminated encephalomyelitis (MDEM). All patients had neurological, routine laboratory and viral serology study with an enzyme-linked immunosorbent assay. Brain and/or spinal cord magnetic resonance imaging (MRI) were performed in 14 children. A follow-up study was in 1-5 years. Typing of DRB1 gene HLA class II was performed in 38 patients. We established that the varicella and rubella groups had preferential patterns. Rubella ADEM is characterized by acute explosive onset, seizures, coma and moderate pyramidal signs, whereas varicella infection is characterized by cerebella ataxia and mild pyramidal dysfunction. The suspected viral aetiology ADEM was characterized by polisymptomatic presentation. MDEM was characterized by older age of patients (11.6 +/- 2.8 years), more severe and prolonged local neurological symptoms, including myelitis symptoms and marked extrapyramidal signs, with distinct demyelination in MRIs. As a whole, ADEM is associated with DRB1*01 and DRB1*017(03) in the Russian population. Thus, ADEM is a separate autoimmune condition with a specific mechanism due to the type of genetic immunoregulatory base and specificity of viral trigger.

[Diagnostic and prognostic significance of the antibodies to the myelin basic protein in acute neuroinfections in children]. / Diagnosticheskoe i prognosticheskoe znachenie antitel k osnovnomu belku mielina pri ostrykh neiroinfektsiiakh u detei.

The development of severe CNS damages including encephalitis is highly probable in some respiratory and exanthemata viral infections (measles, rubella, parotitis). A high level of IgG antibodies to the myelin basic protein was found in patients with parotitis meningitis and rubella encephalitis but it was not high in 80% of patients with encephalitis of the unclear etiology and in 25% of cases with rubella encephalitis. More accurate analysis of clinical, neurovisual and immunologic data revealed a link of appearance of such complications with both the presence of more pronounced demyelinization and prolongation of the disease.

[Neuralgia and zovirax treatment of patients with herpes zoster]. / Nevralgiia i lechenie zoviraksom bol'nykh s opoiasyvaiushchim gerpesom.

AIM: To estimate the occurrence of postherpetic neuralgia (PHN) arising after acute period of herpes zoster (HZ) and determination of zovirax efficiency in PHN prevention. MATERIALS AND METHODS: Of a total of 102 patients with HZ aged 17-89 years, 20 patients aged 26-83 years were given zovirax. RESULTS: Acute pain syndrome in PHN was observed in more that one-third of HZ patients. Patients over 60 years of age were more predisposed to PHN. Zovirax reduced the duration of acute rash and its healing, decreased the number of patients with zoster-associated pain and PHN patients. CONCLUSION: Zovirax is effective and safe in preventing PHN in HZ patients.