The Black Death and Other Pandemics
Scott M. Jackson in Skin Disease and the History of Dermatology, 2023
Numerous other infectious diseases have been postulated as the cause of the Athenian plague. In 2005, researchers claimed to have extracted Salmonella typhi DNA from the teeth of the ancient remains in a mass grave, leading to the conclusion that typhoid fever was the cause of the plague. However, convincing arguments have come forth that the research was flawed.4 And the constellation of mucosal and skin findings described by Thucydides are not seen in typhoid fever, which has “rose spots” (small red flat spots on the torso), as its only skin finding. Other candidates for the Athenian plague are bubonic plague, epidemic typhus, and meningococcemia. Thucydides neglected to mention glandular swellings (buboes) as a feature of the disease, effectively ruling out bubonic plague. Another interesting hypothesis is that the Athenian plague was caused by Ebola hemorrhagic fever.5 Olson et al. point out that the plague was believed by the Greeks to come from Africa. Ebola is also associated with a sudden onset of fever, headache, and pharyngitis, followed by cough, vomiting, diarrhea, severe weakness, a red rash, and hemorrhage from various orifices. Arboviral (mosquito-borne) diseases, which can lead to encephalitis, should also be considered.
Delirium
Henry J. Woodford in Essential Geriatrics, 2022
The limbic system consists of the hippocampus, thalamus, hypothalamus and amygdala (see page 117) located in the medial temporal lobes. Encephalitis is a broad term for brain inflammation. Inflammation of the limbic system can be caused by viral, paraneoplastic or autoimmune processes. A UK study identified 203 cases of encephalitis from 24 hospitals over a two-year period (i.e. around four per hospital per year).43 Cases had a median age of 30. The breakdown of aetiologies was as below:42% infectious (most commonly herpes simplex virus, occasionally Varicella zoster virus or Mycobacterium tuberculosis)37% had unknown causes21% had acute immune-mediated encephalitis
Immunizations
Micha de Winter, Mariëlle Balledux, José de Mare, Ruud Burgmeijer in Screening in Child Health Care, 2018
Measles as a cause of death showed a downward trend as early as 1976. But the effect of introducing immunization is unmistakable (Anonymous 1978a). In infancy and early childhood, measles is in itself a fairly innocuous disease. Immunization therefore serves to prevent complications. In 5% to 15% of cases, secondary bacterial infections develop (otitis media, tracheobronchitis, bronchopneumonia). Encephalitis is seen in one to three patients out of 10,000. Because the disease is relatively rare (100–300 cases per year), it is not always recognized (Roosen & Van Aalderen 1989), or a false-positive diagnosis is made owing to confusion with other exanthematous infectious diseases. From the end of 1987 to the middle of 1988 there was an outbreak of measles, with the highest incidence in the provinces of Zeeland and Flevoland (44.5 and 42.6 cases per 100,000 inhabitants, respectively) (Bijkerk et al. 1989). Through the fast and adequate response of the Community Health Care in collaboration with the District Health Service DGD, the spread of the disease was kept within bounds (Burgmeijer 1988, DGD Flevoland 1989). From time to time local outbreaks of measles are reported, for example in Hilversum in 1992 (Fortuin 1993).
Bilateral Necrotizing Retinitis following Encephalitis Caused by the Pseudorabies Virus Confirmed by Next-Generation Sequencing
Published in Ocular Immunology and Inflammation, 2021
Feng Hu, Jiawei Wang, Xiao-Yan Peng
NGS has been used to detect unexpected pathogens in intraocular fluid in recent years, which has high sensitivity and specificity.9 In this case, the pathogen diagnosis for retinitis was confirmed by detection of PRV in the vitreous specimen. In addition, NGS was negative for PRV in the CSF. In PRV encephalitis patients with ocular involvement, intraocular fluid NGS provides more options and longer time windows for pathogenic detection. The diagnosis of encephalitis was supported by the clinical presentation, CSF tests, and head MRI exams. Additionally, the acute attack and rapid progression of headache, seizure, alternation of consciousness in this case were consistent with reported PRV encephalitis. Requiring ventilator support was also common in PRV encephalitis.1
From blood to brain: blood cell-based biomimetic drug delivery systems
Published in Drug Delivery, 2021
Yong-Jiang Li, Jun-Yong Wu, Jihua Liu, Xiaohan Qiu, Wenjie Xu, Tiantian Tang, Da-Xiong Xiang
Encephalitis is a brain inflammation disease often caused by infection (Mailles et al., 2017). The pathology of brain inflammation cascade is associated with increased migration of immune cells utilizing diapedesis and chemotaxis from blood to brain, crossing the BBB, which breaks down during brain inflammation. Klyachko et al. developed cellular backpacks (micron-scale in size and a few hundred nanometers in thickness) loaded with catalase and attached to the surface of macrophages without affecting the natural functions of the cell carrier (Klyachko et al., 2017). Backpacks loaded with catalase successfully crossed the BBB in lipopolysaccharide (LPS)-induced mouse model of encephalitis and attenuated oxidative stress of microglial cells in the brain. In another study, Yuan et al. utilized naïve macrophage-derived exosomes for brain delivery of brain-derived neurotrophic factor (BDNF) for treating encephalitis (Yuan et al., 2017). They observed that, in the presence of inflammation, the upregulation of intercellular adhesion molecule 1 (ICAM-1) on brain microvessel endothelial cells promoted uptake of macrophage-derived exosomes and facilitated their BBB crossing, and as a result, increased BDNF levels in inflamed brain.
Life after encephalitis: a narrative approach
Published in Neuropsychological Rehabilitation, 2019
Bonnie-Kate Dewar
This is an important resource for professionals working with people affected by encephalitis. Personal narratives deepen our understanding of how the condition affects individuals and families in terms of cognitive and physical changes, challenges to independent living, work and study, in addition to financial strains and changes to lifestyle. Information provided from those affected by encephalitis may thus inform diagnosis and rehabilitation. Yet, importantly, the role of these narratives is to place the professional reader into the shoes of the person affected and thus, hopefully, facilitate understanding and empathy and promote a more “mindful practice”. The challenges of service provision form part of the narratives. The book provides a voice of the individual within this system and acts a source of information for the specific service needs of people affected by encephalitis.
Related Knowledge Centers
- Amnesia
- Confusion
- Fever
- Hallucination
- Inflammation
- Vomiting
- Headache
- Brain
- Brain
- Neck Stiffness
- Seizure