Tick Typhus
James H. S. Gear in CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
The rashes of the acute specific fevers including measles, rubella, and varicella all have well-known typical appearances which are easily recognized and should not be mistaken for that of tick typhus. Coxsackie A and Echo virus infections usually occur in infants and are characterized by a short fever and a maculopapular rash, the papules of which may become vesicular. Some patients develop meningoencephalitis. The severe headache may suggest tick typhus, but there is no primary lesion. The rash is different, and a lumbar puncture will show a pleocytosis greater than that seen in tick typhus.
The nervous system and the eye
C. Simon Herrington in Muir's Textbook of Pathology, 2020
This rare form of encephalitis occurs mainly between the ages of 4 and 20 years and has a prolonged clinical course. It occurs some years after an apparently uncomplicated bout of measles and appears to be due to re-activation of latent measles virus. There are high levels of both IgM and IgG antibodies in the blood and CSF. Microscopic examination shows subacute meningoencephalitis. Neuronophagia is common, and residual neurons may contain intranuclear and/or cytoplasmic inclusion bodies. There is considerable gliosis in the white matter.
Coxsackie B virus
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
Complications of enteroviral meningitis are unusual in an immunocompe-tent child or adult. Spread of virus from the meninges to the brain, resulting in meningoencephalitis, may occur rarely. This may be heralded by an abrupt deterioration in mental state, or the onset of seizures. In patients with immunodeficiencies, particularly those associated with impaired antibody production, meningoencephalitis is much more common, and may become chronic.
Viral metagenomic sequencing in the diagnosis of meningoencephalitis: a review of technical advances and diagnostic yield
Published in Expert Review of Molecular Diagnostics, 2021
Ellen C. Carbo, Ivar Blankenspoor, Jelle J. Goeman, Aloys C.M. Kroes, Eric C.J. Claas, Jutte J.C. De Vries
Meningoencephalitis is a severe inflammation of the brain tissue and meninges, with an overall mortality of 30% and long-term residual sequelae in the majority of the patients that survive [1]. All age groups can be affected and immunocompromised patients are at higher risk of infection with unexpected and novel viral pathogens [2]. Disease outcome improves with a proper and timely diagnosis and correct identification of disease etiology [3]. Strikingly, more than 30% of cases remain without identified etiologic agent [4]. A wide range of causative agents can be involved, and besides host immune status, the etiology is also dependent on geographical location, as exemplified by tick-born encephalitis, Toscana virus encephalitis, and Japanese encephalitis. The clinical severity of the disease in combination with frequent negative routine qPCR panel results and a wide range of causative agents makes this type of patients attractive candidates for metagenomic next-generation sequencing (mNGS), as mNGS can detect all pathogens, including rare and novel pathogens not included in conventional testing.
Anti-NMDA receptor encephalitis: two case reports associated with ovarian teratoma and a literature review
Published in Journal of Obstetrics and Gynaecology, 2019
Javier Sancho-Saúco, Virginia Corraliza-Galán, Jesus Lázaro-Carrasco de la Fuente, Concepcion Sánchez-Martínez, Irene Pelayo-Delgado, Maria Jesus De Pablos-Antona, Elena Cabezas-López, Juan Carlos García-Pérez
Patient two was 33-year-old woman, who had a vaginal delivery five months ago. This patient went to the Emergency Department with the following symptoms: a high fever, generalised headache and behavioural changes for three days. In the Emergency Department, she showed a decreased level of consciousness and sleepiness. Suddenly, she suffered a generalised tonic seizure that lasted for five minutes and had an important postictal period. She needed to be admitted to the ICU to perform cranial CT scan (irrelevant findings) and a lumbar puncture. The patient was diagnosed with meningoencephalitis of an unknown aetiology. Six days later, the results showed that anti-NMDA antibodies were positive and the serum tumour makers were negative. The patient was diagnosed with autoimmune anti-NMDA receptor encephalitis. A pelvic MRI revealed a 15 mm and parietal calcification in right ovary. Transvaginal ultrasound reported an image in the right ovary, with similar characteristics to the teratoma. Laparoscopic right salpingo-oophorectomy was performed and pathologist confirmed the existence of a mature cystic teratoma without immature components inside. One month later after the surgery, anti-NMDA determination was performed in serum and cerebrospinal fluid and they remained positive. No evidence of injury in the left ovary was shown in an ultrasound or pelvic MRI. However, because of a long and slow evolution, intensivists proposed a left salpingo-ooforectomy but the Department of Gynecology refused it. Currently, the patient remains hospitalised in ICU.
The rare manifestations in tuberculous meningoencephalitis: a review of available literature
Published in Annals of Medicine, 2023
Rong li He, Yun Liu, Quanhui Tan, Lan Wang
Microglia release TNF-α And IL-1β and other cytokines play an important role in thrombosis. Leiden mutation of coagulation factor V is the most common cause of hereditary thrombosis. The decrease of anticoagulants and the increase of procoagulant factor (mainly factor V III) activity in patients with TBM lead to blood hypercoagulability and thrombosis [10]. In addition, TBM directly compresses the venous sinus by forming granulation tissue or abscess, and it can also lead to thrombosis by changing hemodynamics [11]. The clinical diagnosis of intracranial venous thrombosis depends on imaging examination [12]. Abnormal high density was found in the lesion area on CT, and related lesions could be seen on MRV. Vein imaging is limited. This disease can be diagnosed by imaging examination. The sensitivity of cranial MRV was about 84% [12]. Patients with tuberculous meningoencephalitis may suddenly have worsening headache, deepening consciousness and seizures during the course of the disease. The possibility of intracranial venous thrombosis should not be ignored [13].
Related Knowledge Centers
- Encephalitis
- Fever
- Inflammation
- Meninges
- Meningitis
- Parenchyma
- Infection
- Headache
- Abnormality
- Personality Changes