Acute varicella zoster encephalitis without evidence of primary vasculopathy in a case-series of 20 patients
| Autor: | Benoit Guery, Jean-Louis Herrmann, Alexandra Mailles, Stephane LEGRIEL, Cédric Bretonnière, Bruno Lina, Jean Paul Stahl, Stéphane Chabrier, Daniel Terral, Marc Lecuit, Benoit Misset, Frederic Laurent, Eric DENES, Cecile Bebear, Bruno POZZETTO, Sylvie ROGEZ, Virginie Prendki, Pierre Clavelou |
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| Přispěvatelé: | Département des maladies infectieuses, Institut de Veille Sanitaire (INVS), service de médecine physique et réadaptation pédiatrique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Bellevue-CHU de Saint-Etienne, Laboratoire de virologie moléculaire et structurale (LVMS), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service de maladies infectieuses et tropicales, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Steering Committee and Investigators Group, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Joseph Fourier - Grenoble 1 (UJF)-Centre National de la Recherche Scientifique (CNRS), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) |
| Rok vydání: | 2011 |
| Předmět: |
Male
Pediatrics Herpesvirus 3 Human MESH: Exanthema viruses Acyclovir medicine.disease_cause Polymerase Chain Reaction MESH: Magnetic Resonance Imaging Cohort Studies 0302 clinical medicine MESH: Aged 80 and over Case fatality rate MESH: Acyclovir 030212 general & internal medicine Prospective Studies Stroke varicella zoster virus MESH: Cohort Studies MESH: Treatment Outcome Cerebrospinal Fluid Encephalitis Varicella Zoster MESH: Aged Aged 80 and over MESH: Middle Aged MESH: Infant Newborn imaging Brain General Medicine Middle Aged Rash MESH: Herpesvirus 3 Human MESH: Infant Magnetic Resonance Imaging 3. Good health Infectious Diseases [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology Treatment Outcome MESH: Survival Analysis Child Preschool Encephalitis Female medicine.symptom Microbiology (medical) MESH: Antiviral Agents Adult medicine.medical_specialty Myelitis MESH: Cerebrospinal Fluid Asymptomatic Antiviral Agents Central nervous system disease 03 medical and health sciences MESH: Brain medicine Humans vasculopathy Aged MESH: Humans business.industry MESH: Child Preschool Varicella zoster virus Infant Newborn MESH: Encephalitis Varicella Zoster Infant MESH: Adult MESH: Polymerase Chain Reaction Exanthema medicine.disease Survival Analysis MESH: Male MESH: Prospective Studies Surgery MESH: DNA Viral Radiography DNA Viral business MESH: Female 030217 neurology & neurosurgery |
| Zdroj: | Clinical Microbiology and Infection Clinical Microbiology and Infection, Elsevier for the European Society of Clinical Microbiology and Infectious Diseases, 2012, 18 (8), pp.808-19. ⟨10.1111/j.1469-0691.2011.03705.x⟩ Clinical Microbiology and Infection, 2012, 18 (8), pp.808-19. ⟨10.1111/j.1469-0691.2011.03705.x⟩ |
| ISSN: | 1469-0691 1198-743X |
| DOI: | 10.1111/j.1469-0691.2011.03705.x⟩ |
| Popis: | International audience; Varicella zoster virus (VZV) is a leading cause of acute viral encephalitis but little is known about its clinical, biological and imaging features. Furthermore, the most favourable treatment regimen has not been determined. We studied a prospective cohort of 20 HIV-negative patients presenting with acute VZV encephalitis caused by primary infection or reactivation. VZV was identified in 16 of 20 cases by PCR detection of the DNA in the cerebrospinal fluid. The four remaining cases occurred during or soon after a VZV rash. The median age of the 17 adults was 76 (19-86) years; the three other patients were children (0.5-5 years). Three patients were immunocompromised. Nine adult patients presented with a rash. Eighteen patients presented with fever and an acute encephalitic syndrome: diffuse brain dysfunction, focal neurological signs, seizures and cranial nerve palsies. Three patients presented with either ventricular or subdural haemorrhage, one with myelitis, and one with asymptomatic stenosis of the middle cerebral artery. The imaging was either normal or revealed non-specific abnormalities such as cortical atrophy but no evidence of stroke. All patients were given acyclovir at various dosages and durations but the case fatality rate remained high (15%) and sequelae were frequently observed either at discharge or at follow-up 3 years later. |
| Databáze: | OpenAIRE |
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