Cases reported "Meningitis, Viral"

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1/4. west nile virus infection transmitted by blood transfusion.

    BACKGROUND: A patient with transfusion-transmitted west nile virus (WNV) infection confirmed by viral culture of a blood component is described. A 24-year-old female with severe postpartum hemorrhage developed fever, chills, headache, and generalized malaise after transfusion of 18 units of blood components; a serum sample and the cerebrospinal fluid tested positive for the presence of WNV IgM antibodies. An investigation was initiated to determine a possible association between transfusion and WNV infection. STUDY DESIGN AND methods: blood donors were assessed for recent infection through questionnaires and WNV testing of serum samples. Whole-blood retention segments and untransfused blood components were sent to the CDC to test for the presence of WNV through PCR (TaqMan, Applied Biosystems), IgM ELISA, plaque reduction neutralization testing, and viral culture. RESULTS: Three of 15 available donor retention segments were WNV PCR-positive. WNV was recovered from one associated blood component. The implicated donor was symptomatic near the time of donation; serology confirmed WNV IgM seroconversion. CONCLUSION: Seroconversion of a symptomatic donor, the presence of viral genetic material in an associated whole-blood retention segment, and recovery of WNV from an associated component provides compelling evidence for transfusion-acquired infection. This report has important implications for blood safety.
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ranking = 1
keywords = retention
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2/4. Low-dose acyclovir for HSV-2 meningitis in a child.

    A 7-y-old girl with genital herpes following sexual abuse presented with dysuria, fever and meningeal signs. acyclovir (15 mg/kg/d for 10 d) was administered for severe genitourinary symptoms. The CSF culture was positive for HSV type 2. Complete resolution of all symptoms demonstrates that, as in adults, HSV-2 meningitis does not require high-dose or prolonged acyclovir therapy.
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ranking = 0.011074191335167
keywords = urinary
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3/4. Acute urinary retention secondary to herpes simplex meningitis.

    We report a case of acute urinary retention in a 24-year-old man with herpes simplex meningitis without genital lesions. Since the differential diagnosis in young patients who present with acute urinary retention also includes multiple sclerosis, lumbosacral disk herniation, rheumatological disorders and drug intoxication, a thorough history and careful neurological examination are of paramount importance in distinguishing these syndromes. As part of a directed neurological evaluation prompt performance of lumbar puncture is indicated; a lymphocytic pleocytosis is suggestive of herpetic meningitis. culture of herpes simplex virus from the cerebrospinal fluid should be attempted. We recommend conservative management only, typically with intermittent catheterization, since bladder function usually normalizes within 10 to 14 days.
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ranking = 58.628450543813
keywords = urinary retention, retention, urinary
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4/4. Systemic herpes simplex virus type 2 infection. proctitis, urinary retention, arthralgias, and meningitis in the absence of primary mucocutaneous lesions.

    A 24-year-old heterosexual man had severe proctalgia associated with nonspecific proctitis. Within a few days, perineal and lower extremity paresthesias, intermittent urinary retention, inguinal lymphadenopathy, lower extremity arthralgias, and aseptic meningitis developed. Serologic studies demonstrated a fourfold rise in convalescent antibody titer to herpes simplex virus (HSV) consistent with an initial type 2 infection. Six months later, HSV type 2 was isolated from perianal vesicles, which we believe was the first cutaneous manifestation of a recurrence. This unusual syndrome, presumably the result of HSV ganglionitis, could be confused with other disorders that include multiple sclerosis, lumbar disk disease with radiculopathy, rheumatologic disease, and psychogenic illness. In the absence of typical herpetic mucocutaneous vesicles, serologic studies may be useful in the diagnosis of a systemic herpes simplex infection.
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ranking = 48.857042119844
keywords = urinary retention, retention, urinary
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