Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 459
Filtrar
1.
Trop Biomed ; 38(3): 435-445, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34608117

RESUMO

Ever since the first reported case series on SARS-CoV-2-induced neurological manifestation in Wuhan, China in April 2020, various studies reporting similar as well as diverse symptoms of COVID-19 infection relating to the nervous system were published. Since then, scientists started to uncover the mechanism as well as pathophysiological impacts it has on the current understanding of the disease. SARS-CoV-2 binds to the ACE2 receptor which is present in certain parts of the body which are responsible for regulating blood pressure and inflammation in a healthy system. Presence of the receptor in the nasal and oral cavity, brain, and blood allows entry of the virus into the body and cause neurological complications. The peripheral and central nervous system could also be invaded directly in the neurogenic or hematogenous pathways, or indirectly through overstimulation of the immune system by cytokines which may lead to autoimmune diseases. Other neurological implications such as hypoxia, anosmia, dysgeusia, meningitis, encephalitis, and seizures are important symptoms presented clinically in COVID-19 patients with or without the common symptoms of the disease. Further, patients with higher severity of the SARS-CoV-2 infection are also at risk of retaining some neurological complications in the long-run. Treatment of such severe hyperinflammatory conditions will also be discussed, as well as the risks they may pose to the progression of the disease. For this review, articles pertaining information on the neurological manifestation of SARS-CoV-2 infection were gathered from PubMed and Google Scholar using the search keywords "SARS-CoV-2", "COVID-19", and "neurological dysfunction". The findings of the search were filtered, and relevant information were included.


Assuntos
COVID-19/patologia , Sistema Nervoso Central/patologia , Doenças do Sistema Nervoso/virologia , Sistema Nervoso Periférico/patologia , Enzima de Conversão de Angiotensina 2/metabolismo , Anosmia/virologia , Sistema Nervoso Central/virologia , Disgeusia/virologia , Encefalite Viral/virologia , Humanos , Meningite Viral/virologia , Doenças do Sistema Nervoso/patologia , Sistema Nervoso Periférico/virologia , SARS-CoV-2 , Convulsões/virologia
2.
Viruses ; 13(8)2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34452304

RESUMO

The sandfly fever Toscana virus (TOSV, genus Phlebovirus, family Phenuiviridae) is endemic in Mediterranean countries. In Spain, phylogenetic studies of TOSV strains demonstrated that a genotype, different from the Italian, was circulating. This update reports 107 cases of TOSV neurological infection detected in Andalusia from 1988 to 2020, by viral culture, serology and/or RT-PCR. Most cases were located in Granada province, a hyperendemic region. TOSV neurological infection may be underdiagnosed since few laboratories include this virus in their portfolio. This work presents a reliable automated method, validated for the detection of the main viruses involved in acute meningitis and encephalitis, including the arboviruses TOSV and West Nile virus. This assay solves the need for multiple molecular platforms for different viruses and thus, improves the time to results for these syndromes, which require a rapid and efficient diagnostic approach.


Assuntos
Infecções por Bunyaviridae/diagnóstico , Líquido Cefalorraquidiano/virologia , Encefalite por Arbovirus/diagnóstico , Meningite Viral/diagnóstico , Vírus da Febre do Flebótomo Napolitano , Automação Laboratorial , Encefalite por Arbovirus/virologia , Humanos , Meningite Viral/virologia , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Vírus da Febre do Flebótomo Napolitano/imunologia , Vírus da Febre do Flebótomo Napolitano/isolamento & purificação , Testes Sorológicos
3.
Am J Trop Med Hyg ; 105(3): 807-812, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34280142

RESUMO

La Crosse virus (LACV) is an arthropod-borne virus that can cause a nonspecific febrile illness, meningitis, or encephalitis. We reviewed U.S. LACV surveillance data for 2003-2019, including human disease cases and nonhuman infections. Overall, 318 counties in 27 states, principally in the Great Lakes, mid-Atlantic, and southeastern regions, reported LACV activity. A total of 1,281 human LACV disease cases were reported, including 1,183 (92%) neuroinvasive disease cases. The median age of cases was 8 years (range: 1 month-95 years); 1,130 (88%) were aged < 18 years, and 754 (59%) were male. The most common clinical syndromes were encephalitis (N = 960; 75%) and meningitis (N = 219, 17%). The case fatality rate was 1% (N = 15). A median of 74 cases (range: 35-130) was reported per year. The average annual national incidence of neuroinvasive disease cases was 0.02 per 100,000 persons. West Virginia, North Carolina, Tennessee, and Ohio had the highest average annual state incidences (0.16-0.61 per 100,000), accounting for 80% (N = 1,030) of cases. No animal LACV infections were reported. Nine states reported LACV-positive mosquito pools, including three states with no reported human disease cases. La Crosse virus is the most common cause of pediatric neuroinvasive arboviral disease in the United States. However, surveillance data likely underestimate LACV disease incidence. Healthcare providers should consider LACV disease in patients, especially children, with febrile illness, meningitis, or encephalitis in areas where the virus circulates and advise their patients on ways to prevent mosquito bites.


Assuntos
Encefalite da Califórnia/epidemiologia , Vírus La Crosse , Meningite Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Encefalite da Califórnia/virologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Meningite Viral/virologia , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
4.
J Clin Lab Anal ; 35(7): e23836, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34152040

RESUMO

BACKGROUND: Despite medical advances, central nervous system (CNS) diseases put a pressure on the health care system. A number of risk factors, especially infectious agents can accelerate the progression of meningitis. As viruses probably account for most cases of meningitis, the diagnosis of them can reduce antibiotic prescriptions. Among various types of infectious diseases, the relationship between two important virus families, including Picornaviridae and Herpesviridae, and meningitis has attracted attraction. METHODS: In this study, one hundred and two samples were collected from patients who experienced symptoms, such as the loss of consciousness, seizures, muscle weakness, fever, headache, rash, and severe dementia, between November 2018 and September 2019. After RNA and DNA extraction, the prevalence of Enterovirus (EV), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes simplex virus type 1 (HSV-1), Herpes simplex virus type 2 (HSV-2), and Varicella zoster virus (VZV) was evaluated using PCR, multiplex PCR, and nested PCR. RESULTS: Results indicated that there were two VZV DNA-positive specimens, while six and five samples were infected with HSV-1 and EBV, respectively. CONCLUSION: We reported that the prevalence of EBV, HSV-1, and VZV in patients, suffering from meningitis cannot be ignored; however, further investigation is needed.


Assuntos
Citomegalovirus/isolamento & purificação , Enterovirus/isolamento & purificação , Herpesvirus Humano 3/isolamento & purificação , Herpesvirus Humano 4/isolamento & purificação , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/virologia , Simplexvirus/isolamento & purificação , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Irã (Geográfico) , Masculino , Adulto Jovem
5.
Neurology ; 97(5): e454-e463, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34088872

RESUMO

OBJECTIVE: To test the hypothesis that enterovirus meningitis (EM) is a frequent and self-limiting condition, the epidemiology of EM in adults was examined. METHODS: Using a prospective, nationwide, population-based database, all adults with EM confirmed by PCR of the CSF from 2015 to 2019 were included. Unfavorable outcome was defined as Glasgow Outcome Scale scores of 1-4 at discharge. Modified Poisson regression was used to compute adjusted relative risks (RRs). RESULTS: A total of 419 cases of EM in 418 adults (46% female, median age 31 years [interquartile range (IQR) 27-35]) yielded an incidence of 1.80/100,000/year. Admission diagnoses included CNS infection 247/397 (62%), other neurologic conditions 89/397 (22%), and cerebrovascular diseases 33/397 (8%). Genotype was available for 271 cases, of which echovirus 30 accounted for 155 (57%). Patients presented with headache 412/415 (99%), history of fever 303/372 (81%), photophobia 292/379 (77%), and neck stiffness 159/407 (39%). Fever (≥38.0°C) was observed in 192/399 (48%) at admission. The median CSF leukocyte count was 130 106/L (range 0-2,100) with polymorphonuclear predominance (>50%) in 110/396 (28%). Cranial imaging preceded lumbar puncture in 127/417 (30%) and was associated with non-CNS infection admission diagnoses and delayed lumbar puncture (median 4.8 hours [IQR 3.4-7.9] vs 1.5 [IQR 0.8-2.8], p < 0.001). Unfavorable outcome occurred in 99/419 (24%) at discharge; more often in female patients (RR 2.30 [1.58-3.33]) and less frequent in echovirus 30 (RR 0.67 [0.46-1.00]) in adjusted analyses. Outcome remained unfavorable in 22/379 (6%) after 6 months. CONCLUSIONS: EM is common among young, healthy adults. Although the long-term prognosis remains reassuring, a substantial proportion have moderate disability at discharge, especially female patients.


Assuntos
Infecções por Enterovirus/epidemiologia , Meningite Viral/epidemiologia , Adolescente , Adulto , Bases de Dados Factuais , Dinamarca/epidemiologia , Infecções por Enterovirus/líquido cefalorraquidiano , Infecções por Enterovirus/virologia , Feminino , Escala de Resultado de Glasgow , Humanos , Contagem de Leucócitos , Masculino , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/virologia , Pessoa de Meia-Idade , Distribuição de Poisson , Reação em Cadeia da Polimerase , Estudos Prospectivos , Medição de Risco , Resultado do Tratamento , Adulto Jovem
6.
BMC Infect Dis ; 21(1): 405, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933008

RESUMO

BACKGROUND: Aseptic meningitis is most often caused by enteroviruses (EVs), but EVs associated with aseptic meningitis have not yet been reported in Liaocheng. The aim of this study was to determine the prevalence and genetic characteristics of EVs causing aseptic meningitis in children in Liaocheng. METHODS: We reviewed the epidemiological and clinical characteristics of 504 paediatric cases of aseptic meningitis in Liaocheng from 2018 to 2019 and analysed the phylogeny of the predominant EV types causing this disease. RESULTS: A total of 107 children were positive for EV in cerebrospinal fluid samples by nested PCR. Most of the positive patients were children 13 years old or younger and had symptoms such as fever, headache and vomiting (P < 0.05). The seasons with the highest prevalence of EV-positive cases were summer and autumn. The 107 EV sequences belonged to 8 serotypes, and echovirus types 18, 6 and 11 were the three dominant serotypes in Liaocheng during the 2-year study period. Phylogenetic analyses demonstrated that the E18 and E6 isolates belonged to subgenotype C2, while the E11 isolates belonged to subgenotype D5. VP1 analysis suggested that only one lineage of these three types was cocirculating in the Liaocheng region. CONCLUSIONS: This study demonstrated the diverse EV genotypes contributing to a large outbreak of aseptic meningitis in Liaocheng. Therefore, large-scale surveillance is required to assess the epidemiology of EVs associated with aseptic meningitis and is important for the diagnosis and treatment of aseptic meningitis in Liaocheng.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/genética , Meningite Asséptica/líquido cefalorraquidiano , Meningite Asséptica/epidemiologia , Meningite Viral/líquido cefalorraquidiano , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Surtos de Doenças , Enterovirus/isolamento & purificação , Infecções por Enterovirus/líquido cefalorraquidiano , Infecções por Enterovirus/epidemiologia , Infecções por Enterovirus/etiologia , Feminino , Genótipo , Humanos , Lactente , Masculino , Meningite Asséptica/etiologia , Meningite Asséptica/virologia , Meningite Viral/epidemiologia , Meningite Viral/virologia , Filogenia , Estações do Ano
7.
Medicine (Baltimore) ; 100(18): e25706, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950953

RESUMO

ABSTRACT: Enteroviruses is a group of positive single-stranded RNA viruses ubiquitous in the environment, which is a causative agent of epidemic diseases in children and infants. But data on neonates are still limited. The present study aimed to describe the clinical characteristics of enterovirus infection in neonates and arise the awareness of this disease to general public.Between March 2018 and September 2019, data from all of the neonates diagnosed with enterovirus infection were collected and analyzed from neonatal intensive care unit of Zhangzhou Hospital in Fujian, China.A total of 23 neonates were enrolled. All of them presented with fever (100%), and some with rashes (39.1%). The incidence of aseptic meningitis was high (91.3%), but only a small proportion (28.6%) presented with cerebrospinal fluid (CSF) leukocytosis. The positive value for nucleic acid detection in CSF was significantly higher than throat swab (91.3% vs 43.5%, P = .007). Five of the infected neonates presented with aseptic meningitis (23.8%) underwent brain magnetic resonance imaging examination and no craniocerebral injuries were found. Subsequent follow-ups were performed in 15 of them (71.4%) and no neurological sequelae was found.Aseptic meningitis is a common type of enterovirus infection in neonates with a benign course. Nucleic acid detection of CSF has an important diagnostic value. Febrile neonates would be suggested to screen for enterovirus infection in addition to complete septic workup. An unnecessary initiation or earlier cessation of antibiotics could be considered in enterovirus infection, but that indications still need further studies to guarantee the safety.


Assuntos
Infecções por Enterovirus/epidemiologia , Enterovirus/isolamento & purificação , Febre/epidemiologia , Meningite Asséptica/epidemiologia , Meningite Viral/epidemiologia , Encéfalo/diagnóstico por imagem , China/epidemiologia , Enterovirus/genética , Infecções por Enterovirus/líquido cefalorraquidiano , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/virologia , Exantema/líquido cefalorraquidiano , Exantema/diagnóstico , Exantema/epidemiologia , Exantema/virologia , Feminino , Febre/líquido cefalorraquidiano , Febre/diagnóstico , Febre/virologia , Humanos , Incidência , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Imageamento por Ressonância Magnética , Masculino , Meningite Asséptica/líquido cefalorraquidiano , Meningite Asséptica/diagnóstico , Meningite Asséptica/virologia , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/diagnóstico , Meningite Viral/virologia , Faringe/virologia , RNA Viral/líquido cefalorraquidiano , RNA Viral/isolamento & purificação , Estudos Retrospectivos , Dermatopatias Virais/líquido cefalorraquidiano , Dermatopatias Virais/epidemiologia , Dermatopatias Virais/virologia
8.
Elife ; 102021 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-33821792

RESUMO

Meningitis is a potentially life-threatening infection characterized by the inflammation of the leptomeningeal membranes. Many different viral and bacterial pathogens can cause meningitis, with differences in mortality rates, risk of developing neurological sequelae, and treatment options. Here, we constructed a compendium of digital cerebrospinal fluid (CSF) proteome maps to define pathogen-specific host response patterns in meningitis. The results revealed a drastic and pathogen-type specific influx of tissue-, cell-, and plasma proteins in the CSF, where, in particular, a large increase of neutrophil-derived proteins in the CSF correlated with acute bacterial meningitis. Additionally, both acute bacterial and viral meningitis result in marked reduction of brain-enriched proteins. Generation of a multiprotein LASSO regression model resulted in an 18-protein panel of cell- and tissue-associated proteins capable of classifying acute bacterial meningitis and viral meningitis. The same protein panel also enabled classification of tick-borne encephalitis, a subgroup of viral meningitis, with high sensitivity and specificity. The work provides insights into pathogen-specific host response patterns in CSF from different disease etiologies to support future classification of pathogen type based on host response patterns in meningitis.


Assuntos
Meningites Bacterianas/líquido cefalorraquidiano , Meningite Viral/líquido cefalorraquidiano , Proteoma/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistema Nervoso Central/patologia , Encefalite Viral/virologia , Feminino , Interações Hospedeiro-Patógeno , Humanos , Lactente , Masculino , Meninges/patologia , Meningites Bacterianas/microbiologia , Meningite Viral/virologia , Pessoa de Meia-Idade , Modelos Teóricos , Neutrófilos/metabolismo , Proteoma/metabolismo , Proteômica/métodos , Adulto Jovem
10.
J Neurovirol ; 27(3): 444-451, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33788142

RESUMO

Human enteroviruses are the most prevalent causes of aseptic meningitis worldwide. However, despite such predominancy, defining the enteroviral etiology of aseptic meningitis remains a diagnostic dilemma for the clinician in Iran. Therefore, this study was conducted to characterize the prevalence and clinical significance of enteroviral aseptic meningitis as well as the predominant enterovirus serotypes among patients with aseptic meningitis in the South of Iran.Cerebrospinal fluid (CSF) specimens were obtained from 73 patients with aseptic meningitis (52.1% males and 47.9% females), ages ranging from 1 month to 88 years. Following the extraction of nucleic acid, the detection of enteroviruses was performed by RT-PCR, targeting the 5' untranslated region of the genome, and sequencing. Enteroviruses were found in 46.6% of samples (34/73). The most predominant serotype was echovirus 30, followed by coxsackievirus B5 and poliovirus type 1 Sabin strain. The enterovirus infections were more prevalent among female patients (58.8%) and those below 5 years of age (52.9%). Although enterovirus infections were observed throughout the year, the infections were more prevalent during autumn with fever as the predominant clinical symptom. The outcomes revealed that enteroviruses are significant causes of aseptic meningitis in the South of Iran, while suspected cases of aseptic meningitis are usually monitored by bacterial culture and biochemical testing of CSF samples. Therefore, the etiology remains unknown in most cases. Molecular detection of viral pathogens should be included as a common approach in the screening of patients with aseptic meningitis to prevent unnecessary treatment and to improve clinical management.


Assuntos
Enterovirus Humano B/genética , Infecções por Enterovirus/epidemiologia , Meningite Asséptica/epidemiologia , Meningite Viral/epidemiologia , Poliomielite/epidemiologia , Poliovirus/genética , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Enterovirus Humano B/classificação , Enterovirus Humano B/isolamento & purificação , Infecções por Enterovirus/líquido cefalorraquidiano , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/virologia , Feminino , Genoma Viral , Humanos , Lactente , Recém-Nascido , Irã (Geográfico)/epidemiologia , Masculino , Meningite Asséptica/líquido cefalorraquidiano , Meningite Asséptica/diagnóstico , Meningite Asséptica/virologia , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/diagnóstico , Meningite Viral/virologia , Pessoa de Meia-Idade , Epidemiologia Molecular , Filogenia , Poliomielite/líquido cefalorraquidiano , Poliomielite/diagnóstico , Poliomielite/virologia , Poliovirus/classificação , Poliovirus/isolamento & purificação , Prevalência , RNA Viral/genética
11.
Arch Virol ; 166(2): 335-345, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33392820

RESUMO

Meningitis is a serious condition that affects the central nervous system. It is an inflammation of the meninges, which is the membrane that surrounds both the brain and the spinal cord. Meningitis can be caused by bacterial, viral, or fungal infections. Many viruses, such as enteroviruses, herpesviruses, and influenza viruses, can cause this neurological disorder. However, enteroviruses have been found to be the underlying cause of most viral meningitis cases worldwide. With few exceptions, the clinical manifestations and symptoms associated with viral meningitis are similar for the different causative agents, which makes it difficult to diagnose the disease at early stages. The pathogenesis of viral meningitis is not clearly defined, and more studies are needed to improve the health care of patients in terms of early diagnosis and management. This review article discusses the most common causative agents, epidemiology, clinical features, diagnosis, and pathogenesis of viral meningitis.


Assuntos
Meningite Viral/diagnóstico , Meningite Viral/virologia , Animais , Humanos , Vírus/patogenicidade
12.
J Med Virol ; 93(1): 550-558, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32672843

RESUMO

Since the discovery of coronavirus disease 2019 (COVID-19), a disease caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathology showed different faces. There is an increasing number of cases described as (meningo)encephalitis although evidence often lacks. Anosmia, another atypical form of COVID-19, has been considered as testimony of the potential of neuroinvasiveness of SARS-CoV-2, though this hypothesis remains highly speculative. We did a review of the cases reported as brain injury caused by SARS-CoV-2. Over 98 papers found, 21 were analyzed. Only four publications provided evidence of the presence of SARS-CoV-2 within the central nervous system (CNS). When facing acute neurological abnormalities during an infectious episode it is often difficult to disentangle neurological symptoms induced by the brain infection and those due to the impact of host immune response on the CNS. Cytokines release can disturb neural cells functioning and can have in the most severe cases vascular and cytotoxic effects. An inappropriate immune response can lead to the production of auto-antibodies directed toward CNS components. In the case of proven SARS-CoV-2 brain invasion, the main hypothesis found in the literature focus on a neural pathway, especially the direct route via the nasal cavity, although the virus is likely to reach the CNS using other routes. Our ability to come up with hypotheses about the mechanisms by which the virus might interact with the CNS may help to keep in mind that all neurological symptoms observed during COVID-19 do not always rely on CNS viral invasion.


Assuntos
COVID-19/diagnóstico , COVID-19/patologia , Sistema Nervoso Central/virologia , Encefalite Viral/patologia , Meningite Viral/virologia , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Anosmia , Encéfalo/virologia , Criança , Feminino , Humanos , Masculino , Meningite Viral/patologia , Pessoa de Meia-Idade , Adulto Jovem
13.
Pediatr Infect Dis J ; 40(2): e87-e98, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33181787

RESUMO

We report first viral meningitis associated with coronavirus disease 2019 (COVID-19) in a patient hospitalized at Imam Hassan Hospital in Bojnurd. The patient was a 9-year-old child with no history of internal disease who referred to the emergency with a complaint of fever, headache and low back pain, about 3 days after the onset of symptoms. finally, viral meningitis was diagnosed with COVID-19.


Assuntos
COVID-19/complicações , COVID-19/fisiopatologia , Meningite Viral/complicações , Meningite Viral/fisiopatologia , COVID-19/diagnóstico , Criança , Serviço Hospitalar de Emergência , Feminino , Febre , Hospitalização , Humanos , Irã (Geográfico) , Dor Lombar , Meningite Viral/diagnóstico , Meningite Viral/virologia , SARS-CoV-2/isolamento & purificação , Tórax/diagnóstico por imagem
14.
J Med Virol ; 93(6): 3389-3396, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32880992

RESUMO

BACKGROUND: Viral meningitis is the most common type of meningitis. Worldwide, nonpolio enteroviruses (NPEVs) account for 23%-60% of all cases of viral meningitis. We aimed to detect NPEV among aseptic meningitis cases using reverse transcription-polymerase chain reaction (RT-PCR) and evaluate molecular testing versus clinical and laboratory parameters. PATIENTS AND METHODS: A 2-year prospective study was conducted for all clinically suspected meningitis patients, who underwent lumbar puncture in Alshatby University and Alexandria Fever Hospitals. Clinical manifestations were reviewed; cytological, microbiological, and biochemical examinations were done. One-step RT-PCR for NPEV was introduced to a routine workflow using Pan-Enterovirus primers. RESULTS: Out of 2519 patients, 994 (40%) patients were found to have positive cerebrospinal fluid findings, out of which 716 (72%) patients had positive findings of aseptic meningitis. Ninety-four samples were randomly selected and divided across four age groups: neonates, infants, children, and adults. The significant difference was found among adult patients regarding fever, vomiting, headache, signs of meningeal irritation, cranial nerve affection, and focal neurological deficits (p ≤ .05). Seven cases (7.4%) were found to be NPEV positive by RT-PCR. Positive NPEV PCR samples were shown to be statistically significant among neonates (p ≤ .05). The statistical significance was found among the NPEV group regarding the length of hospital stay and duration of IV antibiotic intake while no statistical significance was found with any clinical or laboratory findings. CONCLUSION: RT-PCR was reliable to identify NPEV while clinical and laboratory findings were inconclusive. NPEV showed low incidence and slight seasonal variation which rings the bell to investigate other causes of viral meningitis throughout the year.


Assuntos
Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/epidemiologia , Enterovirus/genética , Meningite Asséptica/epidemiologia , Meningite Asséptica/virologia , Meningite Viral/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Técnicas de Laboratório Clínico/estatística & dados numéricos , Egito/epidemiologia , Enterovirus/classificação , Enterovirus/isolamento & purificação , Enterovirus/patogenicidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningite Asséptica/líquido cefalorraquidiano , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/epidemiologia , Meningite Viral/virologia , Estudos Prospectivos , RNA Viral/genética , Adulto Jovem
15.
BMC Infect Dis ; 20(1): 788, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33096990

RESUMO

BACKGROUND: Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. METHODS: A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. RESULTS: A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. CONCLUSION: Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Criptococose/diagnóstico , Cryptococcus neoformans/imunologia , HIV/genética , Meningite Fúngica/diagnóstico , Meningite Viral/diagnóstico , Mycobacterium tuberculosis/genética , Projetos de Pesquisa , Tuberculose Meníngea/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Doença Crônica , Criptococose/microbiologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Meningite Fúngica/líquido cefalorraquidiano , Meningite Fúngica/microbiologia , Meningite Viral/líquido cefalorraquidiano , Meningite Viral/virologia , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Estudos Retrospectivos , Sensibilidade e Especificidade , Tuberculose Meníngea/líquido cefalorraquidiano , Tuberculose Meníngea/microbiologia , Adulto Jovem
16.
Neurol Sci ; 41(11): 3021-3022, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32875474

RESUMO

In December 2019, a new coronavirus infection was identified in China. Although the clinical presentation of COVID-19 is predominantly respiratory, more than 35%% of patients have neurological symptoms. We report an elderly female with asthenia, dry cough, anosmia, ageusia, fever, nausea, and a severe and persistent headache. She had confirmed COVID-19 using the nasal swab RT-PCR technique. Her cranial tomography was normal. The CSF analysis demonstrated a cell count of 21 cells/mm3 (80% lymphocytes and 20% monocytes), 34 mg/dl protein, and 79 mg/dl glucose. She improved after 4 days. Our report draws attention to the meningeal involvement of SARS-Cov-2.


Assuntos
Infecções por Coronavirus/líquido cefalorraquidiano , Infecções por Coronavirus/complicações , Cefaleia/etiologia , Leucocitose/líquido cefalorraquidiano , Pneumonia Viral/líquido cefalorraquidiano , Pneumonia Viral/complicações , Idoso , Betacoronavirus , COVID-19 , Feminino , Humanos , Meningite Viral/virologia , Pandemias , SARS-CoV-2
18.
J Neurovirol ; 26(4): 459-473, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32737861

RESUMO

Seven coronavirus (CoV) species are known human pathogens: the epidemic viruses SARS-CoV, SARS-CoV-2, and MERS-CoV and those continuously circulating in human populations since initial isolation: HCoV-OC43, HCoV-229E, HCoV-HKU1, and HCoV-NL63. All have associations with human central nervous system (CNS) dysfunction. In infants and young children, the most common CNS phenomena are febrile seizures; in adults, non-focal abnormalities that may be either neurologic or constitutional. Neurotropism and neurovirulence are dependent in part on CNS expression of cell surface receptors mediating viral entry, and host immune response. In adults, CNS receptors for epidemic viruses are largely expressed on brain vasculature, whereas receptors for less pathogenic viruses are present in vasculature, brain parenchyma, and olfactory neuroepithelium, dependent upon viral species. Human coronaviruses can infect circulating mononuclear cells, but meningoencephalitis is rare. Well-documented human neuropathologies are infrequent and, for SARS, MERS, and COVID-19, can entail cerebrovascular accidents originating extrinsically to brain. There is evidence of neuronal infection in the absence of inflammatory infiltrates with SARS-CoV, and CSF studies of rare patients with seizures have demonstrated virus but no pleocytosis. In contrast to human disease, animal models of neuropathogenesis are well developed, and pathologies including demyelination, neuronal necrosis, and meningoencephalitis are seen with both native CoVs as well as human CoVs inoculated into nasal cavities or brain. This review covers basic CoV biology pertinent to CNS disease; the spectrum of clinical abnormalities encountered in infants, children, and adults; and the evidence for CoV infection of human brain, with reference to pertinent animal models of neuropathogenesis.


Assuntos
Infecções por Coronavirus , Meningite Viral/patologia , Meningite Viral/virologia , Pandemias , Pneumonia Viral , Animais , Betacoronavirus , COVID-19 , Coronaviridae , Infecções por Coronaviridae/virologia , Humanos , SARS-CoV-2
19.
J Neurovirol ; 26(4): 565-571, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32524423

RESUMO

The aim of our study was to compare the course of TBE in children and adults. A retrospective analysis of the medical records of 669 patients was performed. The patients were categorized into 2 groups: Group I with 68 children and group II with 601 adults. TBE symptoms in children were milder compared with adults, with meningitis in 97% of cases. In adults, meningoencephalitis and meningoencephalomyelitis made up 49.26% of cases. Nausea and vomiting are more frequent in children, while neurological manifestations are more frequent in adults. There were no differences in CSF pleocytosis at the onset of disease in both groups, while CSF protein concentration was higher in adults. Children treated with corticosteroids over 7 days had higher checkup pleocytosis than pleocytosis at the onset of disease compared with adults. Corticosteroid use prolongs the disease duration but does not influence the development of TBE sequelae. Children had more favourable outcomes than adult patients.


Assuntos
Vírus da Encefalite Transmitidos por Carrapatos/patogenicidade , Encefalite Transmitida por Carrapatos/patologia , Encefalite Viral/patologia , Leucocitose/patologia , Meningite Viral/patologia , Meningoencefalite/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Criança , Pré-Escolar , Dexametasona/uso terapêutico , Vírus da Encefalite Transmitidos por Carrapatos/fisiologia , Encefalite Transmitida por Carrapatos/diagnóstico , Encefalite Transmitida por Carrapatos/tratamento farmacológico , Encefalite Transmitida por Carrapatos/virologia , Encefalite Viral/diagnóstico , Encefalite Viral/tratamento farmacológico , Encefalite Viral/virologia , Feminino , Humanos , Leucocitose/diagnóstico , Leucocitose/tratamento farmacológico , Leucocitose/virologia , Masculino , Manitol/uso terapêutico , Meningite Viral/diagnóstico , Meningite Viral/tratamento farmacológico , Meningite Viral/virologia , Meningoencefalite/diagnóstico , Meningoencefalite/tratamento farmacológico , Meningoencefalite/virologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
20.
Artigo em Russo | MEDLINE | ID: mdl-32323946

RESUMO

OBJECTIVE: To describe a rare case of enterovirus disease with meningitis in an infant. MATERIAL AND METHODS: Summary of medical records of the child and his mother were used. RESULTS AND CONCLUSION: The medical history, characteristics of the clinical picture, the composition of the cerebrospinal fluid (CSF) for laboratory confirmed Coxsackie B1-6 with meningitis in the infant, aged 1 month, and his mother, 40 years old, the source of which were older children who had the infection in the form of a «minor illness¼, are presented. Enterovirus RNA was detected by PCR in pleocytosis 984/3 on the 4th (in a child) and cytosis 18/3 on the 5th day (in a mother) in the two-wave course of the disease. Data on clinical forms of enterovirus infection in children, aged 0-12 months, the frequency of cases and clinical signs of enterovirus meningitis in infants are considered.


Assuntos
Infecções por Enterovirus/virologia , Enterovirus/isolamento & purificação , Meningite Viral/virologia , Adulto , Enterovirus/genética , Feminino , Humanos , Lactente , Recém-Nascido , Leucocitose , Masculino , Mães , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/virologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...