China
Africa
Explore chapters and articles related to this topic
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
All patients should have an LP, with measurement of OP, and have CSF analyzed for cell count and differential, protein, glucose, Gram stain and culture, acid-fast smear and culture, fungal stains and culture, PCR for HSV, PCR for enteroviruses, VDRL, and cytology. In general, viral cultures are insensitive and have largely been replaced by PCR testing. It is very important to test for HSV by PCR because this entity is often fatal if untreated. During the appropriate season, and depending on geography, one should consider anti-WNV IgM and testing for antibodies against other arboviruses (see below). If the patient is immunocompromised, consider sending Toxoplasma PCR, cryptococcal antigen and PCR testing for VZV, CMV, EBV, HHV-6, and JC virus. As discussed in the Aseptic Meningitis section, a multiplex PCR for meningitis/encephalitis is commercially available and tests for many of the above viral pathogens (HSV-1 and -2, HHV-6, CMV, EBV, VZV, enterovirus, and parechovirus). In general, CSF will show an increased WBC count (<250 cells/μL) with lymphocytic predominance, mildly increased protein (<150 mg/dL), and normal glucose. Many of these pathogens, but particularly HSV, lead to hemorrhagic necrosis of the brain parenchyma, resulting in CSF predominated by RBC.
Neonatal sepsis
Published in Prem Puri, Newborn Surgery, 2017
Jamie Golden, Jessica A. Zagory, Christopher P. Gayer, Tracy C. Grikscheit, Henri R. Ford
Neonatal viruses have been increasingly identified in infants evaluated for bacterial sepsis despite the lack of clinical indicators.96,97 The VIRIoN-I study prospectively evaluated the incidence of respiratory viral infections and found that 6% of NICU sepsis evaluations had a viral infection detected.96 Infants diagnosed with a respiratory virus had a longer hospital stay and were more commonly diagnosed with bronchopulmonary dysplasia (BPD).97 Neonatal viral infections include coronavirus, enterovirus, human metapneumovirus, influenza, parainfluenza virus, respiratory syncytial virus, rhinovirus, herpes simplex virus, coxsackievirus, echovirus, cytomegalovirus, human immunodeficiency virus, varicella-zoster, rubella virus, influenza, and parechovirus.28,36 Antivirals such as acyclovir, ganciclovir, and oseltamivir can be used in the treatment of infected neonates and have improved the morbidity and mortality associated with viral infection.28,36
Case 18: First Fit
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
The fluctuation in her condition was felt to possibly represent episodes of non-convulsive seizures and she was commenced on 250 mg levetiracetam BD and the aciclovir was continued. The viral screen performed on her CSF samples was negative for HSV, varicella-zoster virus (VZV), enterovirus and parechovirus.
Recombinant parechovirus A3 possibly causes various clinical manifestations, including myalgia; findings in Yamagata, Japan in 2019
Published in Infectious Diseases, 2022
Katsumi Mizuta, Tsutomu Itagaki, Shuji Chikaoka, Manabu Wada, Toru Ikegami, Dai Sendo, Chifumi Iseki, Yukitoshi Shimizu, Shuichi Abe, Kenichi Komabayashi, Yoko Aoki, Tatsuya Ikeda
The human parechoviruses are members of the genus Parechovirus in the Picornaviridae family, which is comprised of six species (Parechovirus A through F) [1–3]. Parechovirus A (PeVA) is the most important pathogen in humans, with 19 types currently identified [1,2]. The Parechovirus genome is approximately 7.35 kb long and is organized into a single open reading frame with 5′ and 3′ nontranslated regions at each end [1,2]. The ORF encodes a polyprotein that consists of three regions: the structural/capsid region P1, and the non-structural regions, P2 and P3. There are 3 PeV capsid proteins, VP0, VP3, and VP1 and 7 non-structural proteins, 2A–2C and 3A–3D [1,2].
Review for Disease of the Year: Treatment of Viral Anterior Uveitis: A Perspective
Published in Ocular Immunology and Inflammation, 2018
Souska Zandi, Bahram Bodaghi, Justus G. Garweg
The clinical relevance of diseases that are induced by emerging viruses such as zika-, influenza A-, Ebola-, or parechovirus14,75–77 and appropriate treatment strategies have yet to be established. As aforementioned, these diseases may follow a self-limiting course, but this is not always the case. The Ebola virus has been reported to persist in the ocular fluids and to reactivate AU in convalescent patients.78
Emerging Viral Infections Causing Anterior Uveitis
Published in Ocular Immunology and Inflammation, 2019
Moncef Khairallah, Padmamalini Mahendradas, Andre Curi, Sana Khochtali, Emmett T. Cunningham
Parechovirus is a small single stranded RNA picornavirus. Parechovirus infections are universal, with a seropositivity of up to 95% in adulthood. Parechovirus infections occur in all age groups, but are more common in young children.110