Cases reported "Herpes Simplex"

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1/12. A baby, a virus, and a rat.

    The authors present a case initially thought to be a child abuse homicide that, after complete autopsy and thorough investigation, was determined to be caused by a viral infection and complicated by postmortem animal activity. Neonatal herpes simplex infection and postmortem skin defects are discussed.
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keywords = animal
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2/12. herpes simplex virus type 1 corneal infection results in periocular disease by zosteriform spread.

    In humans and animal models of herpes simplex virus infection, zosteriform skin lesions have been described which result from anterograde spread of the virus following invasion of the nervous system. Such routes of viral spread have not been fully examined following corneal infection, and the possible pathologic consequences of such spread are unknown. To investigate this, recombinant viruses expressing reporter genes were generated to quantify and correlate gene expression with replication in eyes, trigeminal ganglia, and periocular tissue. Reporter activity peaked in eyes 24 h postinfection and rapidly fell to background levels by 48 h despite the continued presence of viral titers. Reporter activity rose in the trigeminal ganglia at 60 h and peaked at 72 h, concomitant with the appearance and persistence of infectious virus. Virus was present in the periocular skin from 24 h despite the lack of significant reporter activity until 84 h postinfection. This detection of reporter activity was followed by the onset of periocular disease on day 4. Corneal infection with a thymidine kinase-deleted reporter virus displayed a similar profile of reporter activity and viral titer in the eyes, but little or no detectable activity was observed in trigeminal ganglia or periocular tissue. In addition, no periocular disease symptoms were observed. These findings demonstrate that viral infection of periocular tissue and subsequent disease development occurs by zosteriform spread from the cornea to the periocular tissue via the trigeminal ganglion rather than by direct spread from cornea to the periocular skin. Furthermore, clinical evidence is discussed suggesting that a similar mode of spreading and disease occurs in humans following primary ocular infection.
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keywords = animal
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3/12. Naming impairments following recovery from herpes simplex encephalitis: category-specific?

    An apparently clear case of category-specific naming impairment selectively affecting animals was detected in a patient who had recovered from herpes simplex encephalitis. However, subsequent investigation demonstrated that these category-specific effects could be eliminated by controlling simultaneously for three factors in picture naming: word frequency, concept familiarity, and visual complexity. The results emphasize the importance of controlling for all factors pertinent to picture naming when attempting to demonstrate category specificity in picture naming. Further testing indicated that deficits were also apparent when naming to definition was required, and some impairment in the ability to answer questions about objects and living things was also noted. Theoretical implications of these data are considered.
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keywords = animal
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4/12. Herpesnephropathy.

    Two cases of acute renal insufficiency occurred in association with episodes of severe encephalitis due to herpes simplex type I. The possibility was considered that the renal failure was due to viral infection of the kidneys, and animal experiments were carried out in an attempt to confirm this. Young new zealand albino rabbits were infected i. v. with HSV type I; the virus antigen was detected in the kidney of 8 of 10 animals, and IgG was found on the GBM in 9 of 19 animals. Viruria was observed in 12 of the 29 infected animals, and electronmicroscopic examination confirmed the presence of immune complexes in the glomeruli.
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ranking = 4
keywords = animal
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5/12. Progressive esophagitis from acyclovir-resistant herpes simplex. Clinical roles for dna polymerase mutants and viral heterogeneity?

    Clinically acquired acyclovir resistance in herpes simplex has usually been associated with a deficiency in viral thymidine kinase, which, in turn, has been linked with attenuated virulence in animal models. Diminished pathogenicity in thymidine kinase-deficient isolates has been partly responsible for controversies about the clinical significance of antiviral resistance. We report on a series of resistant virus isolates from a patient who had severe, progressive esophagitis. These isolates had various thymidine kinase activities, ranging from 2.8% to 130% when compared with the activity of the isolate obtained before treatment; the resistant isolate 615 retained enzyme activity as well as neurovirulence in an encephalitis model. Plaque purification showed a heterogeneous mixture containing at least one acyclovir-resistant, foscarnet-resistant plaque isolate (615.8) fully able to phosphorylate acyclovir. The 3.3-kbp BamHI fragment containing most of the dna polymerase gene from isolate 615.8 was purified and used to successfully transfer both acyclovir and foscarnet resistance. Acquisition of in-vitro acyclovir resistance was associated with progression of clinical disease, as well as with maintenance of pathogenicity in an animal model and at least one mutation in viral dna polymerase. patients with herpes simplex infections that progress during acyclovir therapy should be observed for acquisition of resistance in the setting of antiviral chemotherapy; future studies should also consider the presence of heterogeneous virus populations in such patients.
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ranking = 2
keywords = animal
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6/12. memory enhancement after physostigmine treatment in the amnesic syndrome.

    Central anticholinergic agents (eg, scopolamine) are known to produce transient memory deficits in human and animal subjects. Damage to the limbic system frequently results from herpes simplex encephalitis (HSE) and produces a memory deficit. If this deficit is due to limbic cholinergic pathway destruction, it might improve with central cholinergic agonists (eg, physostigmine). In a doubleblind study over a three-week period, we compared memory performance on three days after 0.8-mg subcutaneous physostigmine therapy (three sessions) to baseline performance and that obtained in three randomly interspersed control sessions. Serial assessment of memory by the Selective Reminding Test showed reproducible enhancement of long-term storage and retrieval with physostigmine treatment. Performance after control injections did not exceed baseline levels. Our findings encourage the hypothesis that cholinergic mechanisms subserve memory and that their pharmacological potentiation might favorable influence some amnesic conditions.
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keywords = animal
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7/12. skin grafting herpetic ulcers.

    Recurrent and chronic herpetic skin ulcers are associated with the persistence of virus in the dorsal root ganglia serving the respective dermatomes. Descriptions of surgical approaches to control herpetic skin disease have recently appeared in the medical literature. We report the successful excision and skin grafting of chronic genital ulcers. Our subsequent animal studies support our expectations that potential seeding and reinfection of the grafted skin can occur following graft reinnervation. This problem must be watched for following grafts of herpetic ulcers in humans.
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ranking = 1
keywords = animal
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8/12. Western equine encephalitis mimicking herpes simplex encephalitis.

    A patient with severe encephalitis had focal findings suggesting herpes simplex encephalitis. After brain biopsy and administration of vidarabine, the patient's condition improved but was ultimately diagnosed as a case of western equine encephalitis. Further complicating laboratory diagnosis, an endogenous murine coronavirus was isolated from newborn mice inoculated with the patient's brain biopsy tissue. This case illustrates the need for caution in attributing therapeutic responses to antiviral agents or in attributing human illness to viruses that are actually endogenous to animals and tissue culture used in diagnostic virology.
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ranking = 1
keywords = animal
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9/12. Category-specific form-knowledge deficit in a patient with herpes simplex virus encephalitis.

    In-depth case study of a herpes simplex virus encephalitis patient who presents with a relatively clear knowledge disorder and anterograde amnesia in the absence of any other major cognitive deficit. The main neuropsychological feature is a category-specific impairment restricted to living things. The patient misnamed pictures of animals and vegetables, could not accurately draw animals from memory or verbally describe their visual appearance, and was not accurate in sorting pictures of real animals from pictures of unreal animals; conversely, in the same tasks her performance with artifactual objects was either errorless or superior to that with animals. We interpret the patient's category-specific deficit as due to a selective disturbance within the structural description system, rather than a deficit in low-level visual processing or semantic memory. From this case study and a review of other reported cases we claim that such deficit of form-knowledge is a consequence of the extensive lesions that affect bilaterally the inferior parts of the temporal lobes. The patient here described thus offers further empirical evidence for the crucial role of the inferotemporal cortex in processing visual knowledge about concepts.
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ranking = 5
keywords = animal
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10/12. Naming without knowing and appearance without associations: evidence for constructive processes in semantic memory?

    This study describes a patient (SE) with temporal lobe injury resulting from herpes simplex encephalitis, who displayed a previously unreported impairment in which his knowledge of associative and functional attributes of animals was disproportionately impaired by comparison with his knowledge of their sensory attributes (including their visual properties and characteristic sounds). His knowledge of man-made objects was preserved. A striking aspect of the present case was that the patient remained able to name many animals from their pictures, despite making gross errors in generating associative information about these same animals. This suggests that a semantic representation incorporating stored sensory knowledge may be sufficient for naming (at least for biological categories) and associative information may be unnecessary. Semantic knowledge may normally incorporate more information than is necessary for identification. SE's errors were found to be confabulatory and reconstructive in nature and it is argued that this aspect of his performance challenges passive conceptions of semantic memory couched in terms of a catalogue of stored representations. It is proposed that the patient's disorder affects a dynamic, constructive, and inferential component of his knowledge base, and that this component is sensitive to semantic category.
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ranking = 3
keywords = animal
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