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1.
Medicine (Baltimore) ; 98(50): e18289, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852106

RESUMO

INTRODUCTION: More than 1200 different types of microbes were found in the human mouth, only some of these microorganisms were associated with intracranial bacterial infection. However, there are limited data available about the Pseudoramibacter alactolyticus (P alactolyticus) or Mycobacterium tuberculosis (MTB) intracranial infections oral origin. PATIENT CONCERNS: Here, we reported a rarely case with P alactolyticus and MTB coinfection in central nervous after dental extraction. The 44-year-old man presented with progressive headache over the last 2 weeks and a sustained fever >39°C, with a dental extraction performed 2 days before the onset of headache. DIAGNOSIS: P alactolyticus and MTB were confirmed by real-time polymerase chain reaction targeting the16S ribosomal RNA gene. The presence of MTB was also demonstrated by positive acid-fast staining of the purulent discharge. INTERVENTIONS: The patient was treated by metronidazole and anti-TB treatment OUTCOMES:: The patient fully recovered without sequela. CONCLUSION: In conclusion there should be awareness of the possibility of P alactolyticus or MTB intracranial infections following tooth extraction.


Assuntos
Clostridiales/isolamento & purificação , Coinfecção/etiologia , Encefalite Infecciosa/etnologia , Mycobacterium tuberculosis/isolamento & purificação , Extração Dentária/efeitos adversos , Tuberculose do Sistema Nervoso Central/etiologia , Adulto , Antibacterianos/uso terapêutico , Clostridiales/genética , Coinfecção/tratamento farmacológico , Coinfecção/microbiologia , Humanos , Encefalite Infecciosa/tratamento farmacológico , Encefalite Infecciosa/microbiologia , Imagem por Ressonância Magnética , Masculino , Mycobacterium tuberculosis/genética , RNA Bacteriano/análise , Tuberculose do Sistema Nervoso Central/tratamento farmacológico , Tuberculose do Sistema Nervoso Central/microbiologia
2.
Emerg Infect Dis ; 25(5): 898-910, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31002063

RESUMO

During 2003-2011, we recruited 1,065 patients of all ages admitted to Mahosot Hospital (Vientiane, Laos) with suspected central nervous system (CNS) infection. Etiologies were laboratory confirmed for 42.3% of patients, who mostly had infections with emerging pathogens: viruses in 16.2% (mainly Japanese encephalitis virus [8.8%]); bacteria in 16.4% (including Orientia tsutsugamushi [2.9%], Leptospira spp. [2.3%], and Rickettsia spp. [2.3%]); and Cryptococcus spp. fungi in 6.6%. We observed no significant differences in distribution of clinical encephalitis and meningitis by bacterial or viral etiology. However, patients with bacterial CNS infection were more likely to have a history of diabetes than others. Death (26.3%) was associated with low Glasgow Coma Scale score, and the mortality rate was higher for patients with bacterial than viral infections. No clinical or laboratory variables could guide antibiotic selection. We conclude that high-dependency units and first-line treatment with ceftriaxone and doxycycline for suspected CNS infections could improve patient survival in Laos.


Assuntos
Infecções do Sistema Nervoso Central/etiologia , Adolescente , Adulto , Infecções do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/tratamento farmacológico , Criança , Pré-Escolar , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/etiologia , Feminino , Política de Saúde , Humanos , Lactente , Encefalite Infecciosa/etiologia , Encefalite Infecciosa/microbiologia , Encefalite Infecciosa/virologia , Laos , Masculino , Meningite/etiologia , Meningite/microbiologia , Meningite/virologia , Estudos Prospectivos , Adulto Jovem
3.
Med Hypotheses ; 125: 129-136, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30902141

RESUMO

The development of Alzheimer's Disease (AD) might reflect, in its acquired aspects, a cooperative pathogenesis whereby infectious enablers which do not necessarily cross the blood-brain barrier augment the invasive properties of a less virulent organism, thus enabling it to infect the brain. An example interaction is described which involves Chlamydia species, Human papillomavirus (HPV), microbiota, and yeast, where yeast is a pathogen of low virulence which crosses the blood-brain barrier. The cooperative pathogenesis begins at the mucosal epithelium. Infection by Chlamydia, HPV, or dysbiosis of commensal bacteria disrupts the integrity of the mucosal epithelium, thereby allowing colonizing yeast to penetrate the epithelial barrier and enter into the bloodstream. Chlamydia and enabling commensals promote insulin resistance, which provides yeast with glucose and also sets the stage for accumulation of amyloid beta protein (ABP). Meanwhile, HPV-induced and hyperglycemia-induced immunological changes enable the spread of newly invasive yeast to the brain, where the release of inflammatory cytokines in response to yeast promotes production of ABP. Chlamydia also cross reacts with Candida species, which may stimulate further brain inflammation in response to Candida and may augment production of ABP thereby The yeast's less virulent origins, coupled with immune modulation by enablers, might explain why AD as a model of infectious encephalitis is always slow and insidious rather than occasionally febrile, accompanied by seizures, or marked by signs of meningeal inflammation.


Assuntos
Doença de Alzheimer/microbiologia , Doença de Alzheimer/patologia , Barreira Hematoencefálica/patologia , Doença de Alzheimer/virologia , Peptídeos beta-Amiloides/metabolismo , Animais , Transporte Biológico , Encéfalo/patologia , Chlamydia , Infecções por Chlamydia/fisiopatologia , Disbiose , Microbioma Gastrointestinal , Glucose/metabolismo , Humanos , Encefalite Infecciosa/fisiopatologia , Microbiota , Modelos Teóricos , Mucosa Bucal/microbiologia , Infecções por Papillomavirus/fisiopatologia , Prevalência , Sistema Respiratório/microbiologia , Virulência
4.
J Appl Microbiol ; 126(5): 1373-1382, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30835952

RESUMO

AIMS: The aim of this study was to evaluate the genetic diversity and resistance phenotypes of Listeria monocytogenes strains isolated from clinical encephalitis cases, and compare this population to isolates derived from tank milk of healthy animals. METHODS AND RESULTS: A total of 57 L. monocytogenes strains isolated from ruminant's listeriosis cases (n = 31) and from tank milk of healthy ruminants (n = 26) were characterized by species PCR, molecular serotyping, PCR detection of virulence genes, pulsed-field gel electrophoresis and antimicrobial susceptibility testing. All strains possessed inlA, inlC, inlJ, plcA, actA, hlyA and iap virulence-associated genes while serotyping analysis revealed that they were mainly assigned into IVb group. Genotyping revealed 50 pulsotypes among the 57 strains assigned into seven clusters while indistinguishable pulsotypes between clinical and milk strains were not identified. Resistance of L. monocytogenes isolates to 14-16 antimicrobial agents tested was observed and 23 antimicrobial resistance profiles (ARPs) were defined while no apparent predominant ARP type was observed among isolates. CONCLUSIONS: Small ruminants are exposed to a broad range of antimicrobial-resistant as well as genetically diverse strains of L. monocytogenes carrying virulence-associated genes but not all of them associated with the disease. Pulsed-field gel electrophoresis analysis suggests that pulsotypes associated with encephalitis are found in farms only in association with listeriosis. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings are valuable in understanding the ecology of this important food-borne pathogen and creating awareness for the emerging antimicrobial resistance.


Assuntos
Encefalite Infecciosa/microbiologia , Listeria monocytogenes/classificação , Listeriose/microbiologia , Ruminantes/microbiologia , Animais , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado , Grécia , Humanos , Listeria monocytogenes/efeitos dos fármacos , Listeria monocytogenes/genética , Listeria monocytogenes/isolamento & purificação , Leite/microbiologia , Sorotipagem , Fatores de Virulência/genética
5.
Brain Dev ; 41(6): 551-554, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30850156

RESUMO

BACKGROUND: Rhinovirus is a common respiratory pathogen for children throughout the year; nevertheless, its central nervous system involvement is extremely rare, and only two cases have been reported to date: meningitis and sepsis-like illness. PATIENT: A previously healthy 2-year-old Japanese boy developed fever, followed by seizures and lethargy. His cerebrospinal fluid cell count and protein level were slightly increased; brain magnetic resonance imaging showed abnormal intensities in the bilateral cerebellar dentate nuclei, which were prominent in diffusion-weighted images. After his consciousness disturbance improved, cerebellar dysfunction became apparent. He was treated symptomatically, without steroids or any other immunosuppressants. He almost recovered within a few months; however, cerebellar atrophy became evident on brain magnetic resonance imaging. Using acute specimens, human rhinovirus A was detected in his throat swab and cerebrospinal fluid. DISCUSSION: Acute cerebellitis, in which cerebellar inflammation is predominant, is occasionally accompanied by cerebral symptoms, such as consciousness disturbance and seizures. As a causative pathogen, rotavirus is the most common; however, rhinovirus-associated acute encephalitis/encephalopathy and concurrent cerebellitis have not been reported before. Further research, using recent molecular techniques to detect various central nervous system pathogens, including rhinovirus, is needed to delineate the underlying pathophysiology.


Assuntos
Enterovirus/patogenicidade , Encefalite Infecciosa/etiologia , Encefalite Infecciosa/fisiopatologia , Encefalopatias/complicações , Sistema Nervoso Central/virologia , Doenças Cerebelares/patologia , Cerebelo/patologia , Pré-Escolar , Imagem de Difusão por Ressonância Magnética/métodos , Encefalite/patologia , Febre/complicações , Humanos , Japão , Masculino , Rhinovirus/patogenicidade , Rotavirus/patogenicidade , Infecções por Rotavirus/complicações , Convulsões/complicações
7.
Clin Lab ; 65(1)2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30775888

RESUMO

BACKGROUND: In order to increase the detection rate of pathogenic microorganisms in CSF, an improved specimen handling procedure (ISHP) was created. METHODS: This study enrolled encephalitis and control groups, both groups were handled with traditional specimen handling procedure (TSHP) and ISHP. Glutaraldehyde was added to the ISHP. Observed items included: total protein, glucose, chloride, adenosine deaminase, lactate dehydrogenase, sediment, cell and pathogen, Pandy's test. RESULTS: Sediment test of CSF: There was 1 specimen in 10 control specimens tested by TSHP in which Pandy's test was positive; there were 2 specimens tested by ISHP which could see sediment by eye. There was no statistical difference between those two methods (p = 1.000, Table 1). Ten specimens in 23 of the encephalitis group processed by TSHP were positive with Pandy's test; 23 specimens processed by ISHP could all see sediments by eye (Figure 1). There was a statistical difference between the two methods (p = 0.000, Table 1). Pathogen test of CSF: no pathogen was found in the control group processed by TSHP and ISHP. No pathogen was found in the encephalitis group specimens processed by TSHP. Pathogen tests were positive in 7 encephalitis specimens processed by ISHP (p = 0.009, Table 1), which were confirmed as Rickettsia spp. by Gimenze stain (Figure 1B), IFA (Figure 2). CONCLUSIONS: The results revealed that ISHP contributes to the separation of cells, pathogens (such as Rickettsia), and proteins.


Assuntos
Encefalite Infecciosa/líquido cefalorraquidiano , Infecções por Rickettsia/líquido cefalorraquidiano , Rickettsia/fisiologia , Manejo de Espécimes/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Encefalite Infecciosa/diagnóstico , Encefalite Infecciosa/microbiologia , Masculino , Microscopia de Fluorescência , Pessoa de Meia-Idade , Infecções por Rickettsia/diagnóstico , Infecções por Rickettsia/microbiologia , Adulto Jovem
8.
Eur J Clin Microbiol Infect Dis ; 38(4): 631-635, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30680554

RESUMO

Effective antimicrobial therapy depends on several factors including degree of activity against the pathogen, antibiotic resistance, and when relevant, optimal tissue penetration factors. Central nervous system (CNS) infections illustrate these points well. The pharmacokinetic (PK) parameters important in antibiotic blood cerebrospinal fluid barrier (BCB) penetration that is important in meningitis are different and do not predict blood brain barrier (BBB) penetration. Recently, we had a case of Mycoplasma pneumoniae encephalitis (MPE) which prompted a review of the antibiotic PK determinants of BBB penetration which differ markedly from those of BCB penetration important in encephalitis. Using MPE as an illustrative example, this article reviews host and drug factors of therapeutic importance in optimally treating MPE.


Assuntos
Antibacterianos/farmacocinética , Antibacterianos/uso terapêutico , Encefalite Infecciosa/tratamento farmacológico , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma pneumoniae/efeitos dos fármacos , Barreira Hematoencefálica/efeitos dos fármacos , Infecções Bacterianas do Sistema Nervoso Central/tratamento farmacológico , Humanos , Encefalite Infecciosa/microbiologia , Infecções por Mycoplasma/líquido cefalorraquidiano
9.
BMC Infect Dis ; 19(1): 80, 2019 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-30669985

RESUMO

BACKGROUND: Recognizing patients with encephalitis may be challenging. The cardinal symptom, encephalopathy, has a wide array of differential diagnoses. In this prospective study we aimed to explore the etiology of encephalitis and to assess the diagnostic accuracy of symptoms and clinical findings in patients with encephalitis in an encephalopathic population. METHODS: Patients with acute onset of encephalopathy (n = 136) were prospectively enrolled from January 2014-December 2015 at Oslo University Hospital, Ullevaal. Clinical and biochemical characteristics of patients who met the case definition of encephalitis were compared to patients with encephalopathy of other causes. RESULTS: Among 136 patients with encephalopathy, 19 (14%) met the case-definition of encephalitis. For 117 patients other causes of encephalopathy were found, infection outside the CNS was the most common differential diagnosis. Etiology of encephalitis was confirmed in 53% (4 bacterial, 4 viral, 1 parasitic, and 1 autoimmune). Personality change, nausea, fever, focal neurology, recent travel history, and low inflammation markers were significantly more abundant in patients with encephalitis, but the diagnostic accuracy for individual parameters were low (area under the curve (AUC) < 0.7). The combination of fever (OR = 6.6, 95% CI, 1.6-28), nausea (OR = 8.9, 95% CI, 1.7-46) and a normal level of ESR (erythrocyte sedimentation rate < 17 mm/hr, OR = 6.9, 95% CI, 1.5-33) was significant in multivariate analysis with an AUC (area under the curve) of 0.85 (95% CI, 0.76-0.94). Moderately increased pleocytosis in CSF (5-100 × 106/L) further increased the diagnostic accuracy of this combination, AUC 0.90 (95% CI, 0.81-0.98). CONCLUSIONS: There is a wide diversity in differential diagnoses in patients with encephalopathy, and no single symptom or finding can be used to predict encephalitis with high accuracy in this group. The combination of fever, nausea and a low ESR in an encephalopathic population, increased the diagnostic accuracy of encephalitis compared to solitary parameters. The triad could be a useful clinical tool for early diagnosis of encephalitis, and these patients should be considered for further diagnostics such as lumbar puncture (LP).


Assuntos
Encefalopatias/diagnóstico , Encefalite/diagnóstico , Encefalite/etiologia , Adulto , Idoso , Área Sob a Curva , Biomarcadores/análise , Proteínas do Líquido Cefalorraquidiano/análise , Diagnóstico Diferencial , Feminino , Febre/diagnóstico , Febre/etiologia , Humanos , Encefalite Infecciosa/diagnóstico , Encefalite Infecciosa/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Punção Espinal
10.
Buenos Aires; Médica Panamericana; 2019. 160 p. ilus, tab.
Monografia em Espanhol | LILACS | ID: biblio-1026447

RESUMO

Las consultas pediátricas por temas infectológicos son frecuentes y relevantes durante toda la infancia, desde la etapa neonatal hasta la adolescencia. En este nuevo volumen de las Series Garrahan: El ñino y las infecciones, se han seleccionado temas específicos, sobre la base de la actualización del conocimiento, los cambios epidemiológicos y de las conductas clínicas ocurridos en los últimos años y la necesidad del manejo adecuado de estas afecciones, ya sea ambulatorio o durante la internación. Entre sus aspectos sobresalientes se incluyen: El estudio de temas destacados como el abordaje del niño febril; las infecciones de piel y partes blandas, incluidas las asociadas con mordeduras; las infecciones en el recién nacido; las infecciones respiratorias bajas, incluida la tuberculosis; y las infecciones osteoarticulares, del sistema nervioso central e intraabdominales. La inclusión de un capítulo especial sobre la prevención de infecciones para ayudar a reducir su incidencia. El enfoque práctico, con discusión de casos clínicos y definición de conductas, y ubicando al pediatra en un papel central como coordinador de la atención interdisciplinaria. Aspectos clave y lecturas recomendadas en el cierre de cada capítulo. Una obra actualizada que aporta información científica y la experiencia de los profesionales del Hospital Garrahan, dedicada a todos los miembros del equipo de salud que atienden y cuidan niños dondequiera que trabajen al servicio de la salud infantil


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Osteomielite , Peritonite , Pneumonia , Febre Recorrente , Dermatopatias Infecciosas , Tuberculose , Mordeduras e Picadas , Artrite Infecciosa , Coqueluche , Vacinação , Meningites Bacterianas , Antibioticoprofilaxia , Febre , Febre de Causa Desconhecida , Encefalite Infecciosa , Sepse Neonatal
11.
Turk J Pediatr ; 60(3): 340-343, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30511552

RESUMO

Sütçü M, Aktürk H, Gülümser-Sisko S, Acar M, Erol OB, Somer A, Bilgiç B, Salman N. Granulomatous amebic encephalitis caused by Acanthamoeba in an immuncompetent child. Turk J Pediatr 2018; 60: 340-343. Acanthamoeba may lead to granulomatous amebic encephalitis (GAE) with high mortality rates generally in patients with immunosupression and/or chronic disease. Here, we present a rare GAE case, who was a previously healthy child. A Georgian 9 year old boy presented with focal seizure on his left arm and confusion. Since computed tomography (CT) demonstrated hypodense lesion on right occipital lobe, brain biopsy was performed. Histopathological examination of the biopsy material revealed Acanthamoeba cysts and trophozoites together with granulomatous inflammation. The patient, who had no clinical and laboratory findings consistent with immunedeficiency, was diagnosed as GAE. He was treated with a combination drug therapy. Even if it is very rare, amebic meningoencephalitis may also be seen in immunocompetent children, as in our case. Definitive diagnosis is made by microbiological and histopathological examination of brain biopsy material.


Assuntos
Acanthamoeba/isolamento & purificação , Amebíase/diagnóstico , Anti-Infecciosos/uso terapêutico , Infecções Protozoárias do Sistema Nervoso Central/diagnóstico , Encefalite Infecciosa/diagnóstico , Amebíase/tratamento farmacológico , Animais , Encéfalo/parasitologia , Infecções Protozoárias do Sistema Nervoso Central/tratamento farmacológico , Criança , Quimioterapia Combinada , Evolução Fatal , Granuloma/diagnóstico , Humanos , Encefalite Infecciosa/tratamento farmacológico , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
12.
Curr Opin Infect Dis ; 31(6): 463-470, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30299363

RESUMO

PURPOSE OF REVIEW: The delay between first clinical signs and diagnosis of Whipple's disease and Tropheryma whipplei infections is more than 6 years, and relapses are frequently observed, resulting in a need for clinicians to be aware of this infection. RECENT FINDINGS: 18 FDG-PET is useful in the diagnosis and the follow-up of patients (particularly in case of neurological involvement). Histological involvement remains the goldstandard for classic Whipple's disease diagnosis. PCR performed on biopsies of fluid is the main tool for the diagnosis of localized chronic infections. PCR performed on urine samples should become an important role of noninvasive diagnostic strategies, while T. whipplei PCR performed on saliva and stool lack specificity. Because of lifetime susceptibility to T. whipplei and in-vitro susceptibility data, a 1-year course of doxycycline and hydroxychloroquine followed by a lifelong treatment by doxycycline is recommended for Whipple's disease, localized endocarditis and encephalitis. SUMMARY: Clinical involvement of the different T. whipplei infections is well described, as well as the treatment of Whipple's disease, endocarditis and encephalitis. The place of PCR performed on urine remains to be clarified for diagnosis of localized T. whipplei infections and acute infections as well as the optimal treatment for arthritis and acute infections.


Assuntos
Tropheryma , Doença de Whipple , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/microbiologia , Artrite Infecciosa/patologia , Doxiciclina/uso terapêutico , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/patologia , Humanos , Encefalite Infecciosa/diagnóstico , Encefalite Infecciosa/tratamento farmacológico , Encefalite Infecciosa/microbiologia , Encefalite Infecciosa/patologia , Reação em Cadeia da Polimerase , Tomografia por Emissão de Pósitrons , Doença de Whipple/diagnóstico , Doença de Whipple/tratamento farmacológico , Doença de Whipple/microbiologia , Doença de Whipple/patologia
13.
J Neuropathol Exp Neurol ; 77(11): 1001-1004, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30295806

RESUMO

Granulomatous amebic encephalitis is a rare necrotizing infection of the CNS that occurs most commonly in immunocompromised individuals and is usually fatal. It is difficult to diagnose as the clinical symptoms and radiographic findings are often mistaken for other bacterial, viral, fungal, or protozoan infections. Herein, we present the case of a 69-year-old heart transplant recipient who suffered fulminant neurological decline ∼5 months after transplant. Extensive radiographic and laboratory testing did not provide a definite anatomic diagnosis and, despite aggressive clinical treatment, he died. An autopsy examination demonstrated numerous brain abscesses which contained amebic trophozoites and cysts. An indirect immunofluorescence assay performed at the Centers for Disease Control confirmed the presence of Acanthamoeba species. To the best of our knowledge, only 13 other cases of Acanthamoeba amebic encephalitis have been reported in patients who have received solid organ transplants and this is the second case reported in a heart transplant recipient. This case emphasizes that amebic encephalitis should be in the differential diagnosis for immunocompromised patients with new brain lesions found on radiographic imaging.


Assuntos
Acanthamoeba/patogenicidade , Infecções Protozoárias do Sistema Nervoso Central/etiologia , Transplante de Coração/efeitos adversos , Encefalite Infecciosa/etiologia , Idoso , Autopsia , Infecções Protozoárias do Sistema Nervoso Central/diagnóstico por imagem , Evolução Fatal , Humanos , Encefalite Infecciosa/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino
14.
Emerg Infect Dis ; 24(11): 1982-1987, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30334722

RESUMO

We evaluated formalin-fixed paraffin-embedded tissue specimens from 7 patients who died with encephalitic typhus in Hamburg, Germany, during World War II. The archived specimens included only central nervous system tissues >70 years old that had been stored at room temperature. We demonstrated successful detection of Rickettsia typhi DNA by a nested qPCR specific to prsA in 2 patients. These results indicate that R. typhi infections contributed to typhus outbreaks during World War II. Immunohistochemical analyses of brain tissue specimens of R. typhi DNA-positive and -negative specimens showed perivascular B-cell accumulation. Around blood vessels, nodular cell accumulations consisted of CD4-positive and CD8-positive T cells and CD68-positive microglia and macrophages; neutrophils were found rarely. These findings are similar to those of previously reported R. prowazekii tissue specimen testing. Because R. typhi and R. prowazekii infections can be clinically and histopathologically similar, molecular analyses should be performed to distinguish the 2 pathogens.


Assuntos
Surtos de Doenças , Encefalite Infecciosa/parasitologia , Rickettsia typhi/imunologia , Tifo Endêmico Transmitido por Pulgas/parasitologia , Feminino , Alemanha/epidemiologia , Humanos , Imuno-Histoquímica , Encefalite Infecciosa/epidemiologia , Encefalite Infecciosa/patologia , Masculino , Reação em Cadeia da Polimerase em Tempo Real , Rickettsia typhi/genética , Tifo Endêmico Transmitido por Pulgas/epidemiologia , Tifo Endêmico Transmitido por Pulgas/patologia , II Guerra Mundial
15.
Neurol Clin ; 36(4): 687-703, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30366549

RESUMO

Neuroinfectious diseases continue to cause morbidity and mortality worldwide, with many emerging or reemerging infections resulting in neurologic sequelae. Careful clinical evaluation coupled with appropriate laboratory investigations still forms the bedrock for making the correct etiologic diagnosis and implementing appropriate management. The treating physician needs to understand the individual test characteristics of each of the many conventional candidate-based diagnostics: culture, pathogen-specific polymerase chain reaction, antigen, antibody tests, used to diagnose the whole array of neuroinvasive infections. In addition, there is a growing need for more comprehensive, agnostic testing modalities that can identify a diversity of infections with a single assay.


Assuntos
Encefalite Infecciosa/diagnóstico , Meningite/diagnóstico , Meningoencefalite/diagnóstico , Humanos , Meningite/microbiologia , Meningoencefalite/microbiologia
16.
Neurol Clin ; 36(4): 767-787, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30366554

RESUMO

Zika virus (ZIKV) is an arthropod-borne virus that belongs to the Flaviviridae family. Although most cases are mild or go undetected, rare severe neurologic effects, including congenital ZIKV syndrome (CZS) and Guillain-Barré syndrome, have been identified. The serious neurologic complications associated with ZIKV prompted the declaration of the public health emergency of international concern by the World Health Organization. Overall, transmission occurred throughout South and Central America as well as the Caribbean, affecting 48 countries and territories from March 2015 to March 2017. Long-term management of CZS requires a comprehensive combination of supportive services throughout early development.


Assuntos
Infecção por Zika virus/complicações , Síndrome de Guillain-Barré/virologia , Humanos , Encefalite Infecciosa/virologia , Mielite/virologia , Doenças do Sistema Nervoso Periférico/virologia , Zika virus
18.
Bol Med Hosp Infant Mex ; 75(4): 231-236, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30084441

RESUMO

Introducción: Las causas de meningoencefalitis, meningitis o encefalitis pueden ser infecciosas o no infecciosas. Para el diagnóstico microbiológico se requieren cultivos y pruebas moleculares. El objetivo del estudio fue describir las causas infecciosas de meningoencefalitis y su presentación clínica. Métodos: Estudio transversal realizado en el Hospital Civil de Guadalajara Dr. Juan I. Menchaca. Se incluyeron pacientes mayores de 28 días de vida con síndrome de meningitis, encefalitis o meningoencefalitis. Se identificó la etiología infecciosa mediante cultivos, tinciones de Gram y pruebas moleculares de líquido cefalorraquídeo. Se compararon las características de pacientes con y sin diagnóstico etiológico. Resultados: Se incluyeron en el estudio 50 pacientes con meningoencefalitis (n = 25), meningitis (n = 19) o encefalitis (n = 6). La mediana de edad fue de un año y el 62% de los pacientes fueron de sexo masculino. Se realizó diagnóstico etiológico infeccioso en el 42%: el 65.2% (n = 15) se debió a virus y el 34.8% (n = 8) a bacterias. En los pacientes con diagnóstico etiológico, se presentó un mayor número de leucocitos en líquido cefalorraquídeo (92 leu/mm3 vs. 12 leu/mm3, p = 0.001). Fue más frecuente el antecedente de gastroenteritis (razón de momios [RM]: 3.5; intervalo de confianza al 95% [IC 95%]: 1.007-12.1; p = 0.04) y ante la exploración, fue más frecuente la rigidez de cuello (RM: 3.8; IC 95%: 1-15.2; p = 0.04). Conclusiones: El 42% de los pacientes con meningitis, encefalitis o meningoencefalitis tuvieron diagnóstico etiológico infeccioso. La causa más frecuente fue el enterovirus. Background: The etiologies of meningoencephalitis, meningitis or encephalitis may be infectious or non-infectious. For the microbiological diagnosis it is necessary to perform cultures and molecular tests. The objective of this study was to describe the infectious causes of meningoencephalitis and their clinical presentation. Methods: Cross-sectional study performed at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. Patients older than 28 days of life with meningitis, encephalitis or meningoencephalitis syndrome were included in the study. Infectious etiology was identified through cultures, Gram stains, and molecular tests of cerebrospinal fluid. The characteristics of patients with and without etiological diagnosis were compared. Results: Fifty patients with meningoencephalitis (n = 25), meningitis (n = 19) or encephalitis (n = 6) were included in the study. The mean age was one year and 62% were male. An infectious etiological diagnosis was performed in 42%; 65.2 % (n = 15) were viruses and 34.8% (n = 8) bacteria. In patients with etiological diagnosis, a higher number of leukocytes were found in cerebrospinal fluid (92 leu/mm3 vs. 12 leu/mm3, p = 0.001); the history of gastroenteritis was more frequent (odds ratio [OR]: 3.5; 95% confidence interval (CI): 1.007-12.1; p = 0.04) and upon examination, neck stiffness was more common (OR: 3.8; 95% CI: 1-15.2; p = 0.04). Conclusions: 42 % of the patients with meningitis, encephalitis or meningoencephalitis had an infectious etiological diagnosis; the most frequent cause was enterovirus.


Assuntos
Encefalite Infecciosa/diagnóstico , Meningite/diagnóstico , Meningoencefalite/diagnóstico , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/epidemiologia , Feminino , Hospitais , Humanos , Lactente , Recém-Nascido , Encefalite Infecciosa/epidemiologia , Encefalite Infecciosa/microbiologia , Masculino , Meningite/epidemiologia , Meningite/microbiologia , Meningoencefalite/epidemiologia , Meningoencefalite/microbiologia , México , Técnicas Microbiológicas/métodos , Técnicas de Diagnóstico Molecular/métodos
19.
Parasitol Res ; 117(11): 3519-3525, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30112674

RESUMO

Free-living amoebae belonging to Acanthamoeba genus are widely distributed protozoans which are able to cause infection in humans and other animals such as keratitis and encephalitis. Acanthamoeba keratitis is a vision-threatening corneal infection with currently no available fully effective treatment. Moreover, the available therapeutic options are insufficient and are very toxic to the eye. Therefore, there is an urgent need for the development of more effective anti-amoebic agents. Nanotechnology approaches have been recently reported to be useful for the elucidation antimicrobial, antiviral, antifungal and antiprotozoal activities and thus, they could be a good approach for the development of anti-Acanthamoeba agents. Therefore, this study was aimed to explore the activity and cytotoxicity of tannic acid-modified silver nanoparticles, pure silver nanoparticles and pure gold nanoparticles against clinical strains of Acanthamoeba spp. The obtained results showed a significant anti-amoebic effect of the tannic acid-modified silver nanoparticles which also presented low cytotoxicity. Moreover, tannic acid-modified silver nanoparticles were well absorbed by the trophozoites and did not induce encystation. On the other hand, pure silver nanoparticles were only slightly active against the trophozoite stage and pure gold nanoparticles did not show any activity. In conclusion and based on the observed results, silver nanoparticle conjugation with tannic acid may be considered as potential agent against Acanthamoeba spp.


Assuntos
Ceratite por Acanthamoeba/tratamento farmacológico , Acanthamoeba/efeitos dos fármacos , Amebíase/tratamento farmacológico , Antiprotozoários/uso terapêutico , Infecções Protozoárias do Sistema Nervoso Central/tratamento farmacológico , Encefalite Infecciosa/tratamento farmacológico , Nanopartículas Metálicas/uso terapêutico , Taninos/uso terapêutico , Ceratite por Acanthamoeba/parasitologia , Amebíase/parasitologia , Amoeba/efeitos dos fármacos , Animais , Infecções Protozoárias do Sistema Nervoso Central/parasitologia , Ouro/farmacologia , Humanos , Encefalite Infecciosa/parasitologia , Prata/farmacologia , Trofozoítos/efeitos dos fármacos
20.
Front Immunol ; 9: 1648, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30108583

RESUMO

Toxoplasmic encephalitis (TE), an opportunistic infection, is a severe health problem in immunocompromised patients. Previous studies have revealed that C57BL/6 mice are susceptible and BALB/c mice are resistant to TE. To investigate the mechanisms involved in the immunopathogenesis of TE in susceptible C57BL/6 and resistant BALB/c mice, both strains of mice were perorally infected with the Prugniuad (Pru) strain of Toxoplasma gondii. Our results showed that compared with BALB/c mice, C57BL/6 mice infected with T. gondii Pru strain had more severe brain histopathological damage, and higher mRNA expression levels of tachyzoite-specific surface antigen 1, bradyzoite-specific antigen 1, interferon gamma (IFNγ), interleukin (IL)-10, arginase1 (Arg1) (M2 marker), galectin (Gal)-3, Gal-9, T. gondii microneme protein 1 (TgMIC1), TgMIC4, and TgMIC6 during the course of infection by using quantitative real-time reverse transcription-polymerase chain reaction. Further analysis displayed that BALB/c mice showed higher numbers of microglial cells and higher levels of IL-1ß, inducible nitric oxide synthase (iNOS) (M1 marker), and chitinase-3-like protein 3 (Ym1) (M2 marker) in the early infective stage [at day 14 or 35 post infection (p.i.)] compared with C57BL/6 mice, whereas C57BL/6 mice showed higher numbers of microglial cells and higher levels of IL-10, iNOS (M1 marker), and Ym1 (M2 marker) at days 35, 50, or 70 p.i. compared with BALB/c mice. Correlation analysis showed that significant positive correlations existed between Gal-3 and IL-4/IL-10/iNOS/Ym1 and between Gal-9 and IL-4/Ym1 in C57BL/6 mice; between Gal-3 and IFNγ/Arg1 and between Gal-9 and IFNγ/Arg1 in BALB/c mice. Together, our data demonstrated that different Gal-3 and Gal-9 expressions as well as different positive correlations were found between Gal-3 and T helper 1 (Th1)/Th2/M1/M2 cytokines or between Gal-9 and Th1/Th2/M2 cytokines in the brains of T. gondii Pru strain-infected C57BL/6 and BALB/c mice.


Assuntos
Encéfalo/metabolismo , Galectina 3/metabolismo , Galectinas/metabolismo , Encefalite Infecciosa/metabolismo , Microglia/metabolismo , Toxoplasma , Toxoplasmose Cerebral/metabolismo , Animais , Biomarcadores/metabolismo , Encéfalo/imunologia , Citocinas/metabolismo , Predisposição Genética para Doença , Humanos , Encefalite Infecciosa/genética , Encefalite Infecciosa/imunologia , Encefalite Infecciosa/fisiopatologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Microglia/imunologia , Especificidade da Espécie , Toxoplasmose Cerebral/genética , Toxoplasmose Cerebral/imunologia , Toxoplasmose Cerebral/fisiopatologia
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