Congenital Cytomegalovirus Pneumonitis and Treatment Response Evaluation Using Viral Load during Ganciclovir Therapy: a Case Report.

Cytomegalovirus (CMV) is the most common cause of congenital infection. Pneumonitis is considered to be a rare manifestation although congenital CMV infection presents with various non-specific findings. Ganciclovir and valganciclovir are beneficial for improving neurodevelopmental sequelae and hearing outcomes of congenital CMV infection; however, treatment response evaluation is not well reported. We report a female case of congenital CMV infection presenting with pneumonitis, meningoencephalitis, and chorioretinitis. She was treated with intravenous ganciclovir for 6 weeks, and clinical features improved. Measurement of the CMV genome load by real-time polymerase chain reaction assay was performed during treatment. After the administration of ganciclovir, the CMV genome was not detected in the blood and levels decreased gradually in the urine. Physicians should consider the possibility of congenital CMV infection in neonates who present with respiratory distress. Furthermore, measurement of the CMV genome load in blood and urine may be useful for evaluating treatment response.

[Curable dementia revealing late congenital syphilis]. / Démence curable révélant une syphilis congénitale tardive.

UNLABELLED: Late congenital syphilis is a rare disease and its neurological expression is exceptional. We report a case revealed by a curable dementia. CASE REPORT: This 17-year-old patient presented for one year progressive dementia, frontal syndrome and extra pyramidal syndrome. The cerebral CT scan showed a diffuse cortical and subcortical atrophy. Blood and CSF positive antibodies confirmed the diagnosis of late congenital meningoencephalitis due to syphilis. The outcome after 13 months follow-up was favourable with penicillin therapy. COMMENTS: Late congenital syphilis is a rare disease, that may be exceptionally revealed by a curable dementia. Evolution may be favourable with early penicillin therapy.

[The role of congenital Enterovirus infection in the pathogenesis of suppurative and inflammatory diseases in newborn infants]. / Uchastie vrozhdennoi énterovirusnoi infektsii v patogeneze gnoino-vospalitel'nykh zabolevanii u novorozhdennykh.

Newborns with suppurative-inflammatory disease were found to be at high risk of intrauterine infection with Coxsackie enteroviruses from mothers with persistent enterovirus infection; in 54.9%, congenital Coxsackie virus infection was confirmed by virus antigen identification in the urine sediment cells and autopsy material. Coxsackie A viruses were identified in 68.7% of sepsis cases, 42.6% with local purulent infection foci, and in only 6.7% of practically healthy neonates. Specific features of the clinical course are analysed together with the pathohistological picture of congenital enterovirus infection associated with the vertical virus transmission from the mother having a persistent form of this infection. A suggestion is proposed that the severe course of suppurative-inflammatory conditions and the general character of neonatal bacterial infection are largely determined by the immunodeficient states which are etiologically related to congenital enterovirus infections.

[Pathological anatomy of herpetic brain lesions in infants]. / Patologicheskaia anatomiia gerpeticheskikh porazhenii golovnogo mozga u detei.

Results of morphological examination of brain herpetic lesions in 29 children are presented. There were 5 observations of necrotic meningo-encephalitis, among children with generalized intrauterine herpes, less severe changes were found in other cases. 14 children suffered from acute necrotic meningo-encephalitis developed after birth. Changes typical for herpes are described in neural, glial and ependymal cells; the type of response in different forms of lesions is shown. The correlation between the gangliosides content in the brain tissue and the surviving neural cells and a specific increase of ganglioside GD1b fraction in brain tissue were demonstrated by biochemical and morphological studies.

Malakoplakia of the brain. A report of two cases occurring in childhood.

Malakoplakia was found in the brain biopsy specimens of two children with meningoencephalitis probably due to herpes simplex. Histologically, there was extensive parenchymal destruction and cellular infiltration. Numerous von Hansemann histiocytes and typical Michaelis-Gutmann bodies were present. Ultrastructurally these bodies had a dense central core and concentric alternating rings. Large intracytoplasmic phagolysosomes were present. Malakoplakia most frequently involves the urinary tract of adults. Only a few children with malakoplakia have been described. There are two previous reports of cerebral malakoplakia associated with neonatal herpes simplex. The pathogenesis is obscure. Several reports suggest an altered histiocytic response to a bacterial agent as the pathogenetic mechanism. Our findings raise the possibility of an etiologic role of a virus, such as herpes simplex.

Bluetongue virus infection: pathologic responses of nervous systems in sheep and mice.

Lesions caused by bluetongue virus infection of the central nervous systems of sheep and mice vary with age of the host. The character of the lesions appears to be influenced by the stage of immunological maturity of the infected animals.