11/29. Identification of a unique bk virus variant in the CNS of a patient with AIDS.Human polyomavirus BK (BKV; GenBank or EMBL or DDBJ accession no. NC001538) is often reactivated in immunosuppressed patients. Reactivation has been associated primarily with excretion of the virus in the urine, and there have been few reports of renal and/or neurological disease caused by BKV in patients with acquired immunodeficiency syndrome (AIDS). polymerase chain reaction, Southern blotting, and sequencing were used to detect and identify the noncoding control region (NCCR) of BKV in different tissues in an AIDS patient with meningoencephalitis, retinitis, and nephritis. An undescribed reorganized NCCR variant of the virus, completely different from the variants detected in peripheral blood leukocytes (PBLs) and urine, was identified in the cerebrospinal fluid (CSF) and CNS tissues. These results suggest that rearrangements in the NCCR of the virus have resulted in a BKV variant, which is better adapted to the host cell machinery of the cells in CNS tissue. The rearranged variant (BKV CNS) might have been involved in the initiation and/or development of the pathological lesions observed in the CNS-related tissues of this patient.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
12/29. A case of mycoplasma hominis meningo-encephalitis in a full-term infant: rapid recovery after start of treatment with ciprofloxacin.The role of Mycoplasma hominisas a causative agent for neonatal sepsis and meningitis is still unclear. meningitis secondary to M. hominisis well-described in the literature; however, M. hominiscan also be isolated from cerebrospinal fluid (CSF) obtained from infants without signs of meningitis. We present a case of a full-term infant with meningo-encephalitis with seizures, epileptic activity on the EEG, inflammation of brain tissue on a CT scan, and cloudy CSF containing elevated cell counts, decreased glucose levels and elevated protein levels. M. hominiswas identified from the CSF by culture and by polymerase chain reaction (PCR) as the only possible causative agent. Furthermore, while empiric antibiotic and antiviral treatment for neonatal sepsis had failed, the meningo-encephalitis promptly responded upon antibiotic treatment with ciprofloxacin (20 mg/kg per day i.v.), to which M. hominisis susceptible. CONCLUSION: A meningo-encephalitis developed due to infection with M. hominisin a full-term infant, from which he recovered rapidly after start of treatment with ciprofloxacin.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
13/29. Human herpesvirus-6 dna in cerebrospinal fluid of a child with exanthem subitum and meningoencephalitis.The involvement of human herpesvirus-6 (HHV-6) and herpes simplex virus infections was evaluated virologically and serologically in a 13-month-old girl with meningoencephalitic illness occurring in the pre-eruptive stage of exanthem subitum. An isolation of HHV-6 from blood and seroconversion to the virus confirmed the primary infection with the virus. HHV-6 gene sequences were detected in cerebrospinal fluid of acute stage of the disease by polymerase chain reaction. There was no evidence of herpes simplex virus infection in blood and cerebrospinal fluid. The patient recovered from the disease without any sequelae, although abnormal electroencephalography and cerebral computed tomography findings were observed temporally in the acute stage of the disease. These findings strongly suggest that HHV-6 invades the central nervous system and causes meningoencephalitis.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
14/29. Unusual presentation of life-threatening Toscana virus meningoencephalitis.This case report describes a brother and a sister with severe meningoencephalitis caused by Toscana virus (TOSv). The clinical presentation was characterized by stiff neck, deep coma, maculopapular rash, diffuse lymphadenopathy, hepatosplenomegaly, renal involvement, tendency to bleeding, and diffuse intravascular coagulation. The boy had epididymo-orchitis. Recovery with neurologic sequelae as hydrocephalus was observed. Microbiological diagnosis was obtained by serological tests and reverse transcriptase-polymerase chain reaction. Sequencing of polymerase chain reaction products from the S and M segments was carried out. TOSv may be a causative agent in severe meningoencephalitis.- - - - - - - - - - ranking = 2keywords = lyme (Clic here for more details about this article) |
15/29. Rapidly progressive dementia due to mycobacterium neoaurum meningoencephalitis.dementia developed in a patient with widespread neurologic manifestations; she died within 5 months. Pathologic findings showed granulomatous inflammation with caseation necrosis, foreign body-type giant cells, and proliferative endarteritis with vascular occlusions. Broad-range polymerase chain reaction identified mycobacterium neoaurum as the possible pathogen. central nervous system infection by M. neoaurum may result in rapidly progressive dementia.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
16/29. Fatal naegleria fowleri meningoencephalitis, italy.We report the first case of primary amebic meningoencephalitis in italy, in a 9-year-old boy. Clinical course was fulminant, and diagnosis was made by identifying amebas in stained brain sections and by indirect immunofluorescence analysis. naegleria fowleri was characterized as genotype I on the basis of polymerase chain reaction test results.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
17/29. Post-mortem diagnosis of encephalitis in a 75-year-old man associated with human herpesvirus-6 variant A.An HHV-6 variant A infection is described in a 75 year-old man in association with meningoencephalitis identified at autopsy. The patient presented with fever and anorexia, then he developed altered consciousness, motor weakness, progressive lethargy, and coma, and died 21 days after hospital admission. Histopathological examination showed perivascular lymphocytic infiltrates in the central nervous system (CNS). serum and cerebral spinal fluid (CSF) samples drawn from the patient were tested for viruses by a nested polymerase chain reaction (nPCR). HHV-6 primers A and C [Aubin et al., 1991: J Clin Microb 29: 367-372] and HS6AE and HS6AF from [Dewhurst et al. (1993): J Clin Microb 31: 416-418] disclosed a 750 bp genomic product of HHV-6 in both types of biological samples. Restricted site analysis showed that the HHV-6 dna amplified belonged to the variant A of the virus. Short sequences of HHV-6 dna could also be detected in the dna extracted from formalin-fixed, paraffin-embedded sections of CNS tissues by use of one (GM5 and GM6) of three pairs of HHV-6 primers that were selected. Immunohistochemical examination of brain sections, employing a specific monoclonal antibody directed against the HHV-6 gp 102 protein, detected the viral antigen in neurons and glial cells.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
18/29. Enteroviral meningoencephalitis in a patient with non-Hodgkin's lymphoma treated previously with rituximab.A 75-year-old man, with a long history of recurrent lymphoplasmacytoid lymphoma, presented with diffuse large-cell lymphoma affecting adrenal glands and causing severe hypoadrenalism. The lymphoma responded to rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) chemotherapy. Seven months postcompletion of chemotherapy, he developed signs of gastroenteritis and septicaemia. He deteriorated 24 h postadmission with a significant fall in glasgow coma scale Score. polymerase chain reaction testing of cerebrospinal fluid suggested enteroviral encephalitis. He responded symptomatically to intravenous immunoglobulins. His immunoglobulin levels were monitored weekly and supplemented to maintain immunoglobulin g level at 10 g/l, but in spite of this, his neurological condition deteriorated and he died after 14 weeks. Rituximab can cause prolonged B-cell deficiency. We speculate that profound immunosuppression induced by rituximab, together with previous chemotherapy, predisposed this patient to fatal enteroviral meningoencephalitis.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
19/29. Persistent enterovirus infection in culture-negative meningoencephalitis: demonstration by enzymatic rna amplification.Chronic meningoencephalitis due to enterovirus infection can occur in patients with antibody deficiencies. A modified polymerase chain reaction technique demonstrated persistent echovirus 11 infection in such a patient, despite negative routine viral cultures and negative routine nucleic acid hybridization. Although the sequence of echovirus 11 has not yet been determined, genomic conservation among the enteroviruses is significant, permitting detection of echovirus 11 with a primer pair and probe derived from enterovirus serotypes that have been fully sequenced. This study provides the first definitive evidence for the persistence of enterovirus infection with negative viral cultures.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
20/29. Neuroborreliosis simulating a progressive stroke.A 55-year-old man with an onset and course of neurological symptoms of a progressive stroke was found to have a CNS infection caused by the borrelia spirochete. Almost complete recovery was seen after intravenous infusion of bencylpenicillin. Elevated borrelia IgG antibody titers could be seen for long time after recovery. The possibility of an infection due to neuroborreliosis must be considered. If CT scan doesn't show any focal ischemic or hemorrhagic area further investigation with lumbar puncture is necessary in stroke patients.- - - - - - - - - - ranking = 75.052252881445keywords = borrelia (Clic here for more details about this article) |
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