Cases reported "Virus Diseases"

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1/25. Viral infections in interferon-gamma receptor deficiency.

    interferon-gamma receptor deficiency is a recently described immunodeficiency that is associated with onset of severe mycobacterial infections in childhood. We describe the occurrence of symptomatic and often severe viral infections in 4 patients with interferon-gamma receptor deficiency and mycobacterial disease. The viral pathogens included herpes viruses, parainfluenza virus type 3, and respiratory syncytial virus. We conclude that patients with interferon-gamma receptor deficiency and mycobacterial disease have increased susceptibility to some viral pathogens.
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ranking = 1
keywords = herpes
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2/25. Recurrent viral associated hemophagocytic syndrome in a child with Langerhans cell histiocytosis.

    Langerhans cell histiocytosis (LCH) with subsequent viral-associated hemophagocytic syndrome (VAHS) or secondary hemophagocytic lymphohistiocytosis (HLH) is extremely rare. A 15-month-old girl with disseminated LCH experienced three episodes of VAHS during maintenance therapy. Viral infection, with influenza A, herpes simplex, and adenovirus, respectively, was documented at each episode. She recovered each time after interruption of maintenance therapy. The occurrence of fever and pancytopenia in patients with chemotherapy-treated LCH can be associated with VAHS and not with relapsing LCH.
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ranking = 1
keywords = herpes
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3/25. HLA-mismatched CD34-selected stem cell transplant complicated by HHV-6 reactivation in the central nervous system.

    We report here a patient who suffered from PCR- confirmed human herpesvirus type 6 (HHV-6) meningoencephalitis after allogeneic purified CD34 cell transplantation from his HLA-mismatched sibling donor, even though he had been on intense prophylaxis with i.v. ganciclovir (GCV), acyclovir (ACV) and gamma-globulin containing a specific antibody against HHV-6. Serological evaluation disclosed that both the donor and recipient had IgG antibody against HHV-6 before transplantation. His blood WBC count started to transiently increase on day 10, and all blood components had decreased by day 20. He then developed a severe headache and high blood pressure, and sporadic abnormal neurological findings including nystagmus and delirium. An analysis of cerebrospinal fluid (CSF) revealed 8 cells/microl, a glucose level of 130 mg/dl and a protein level of 201 mg/dl (normal, 50 mg/dl) on day 26. At the time, HHV-6 was detected only in CSF by a PCR-based method and he was diagnosed as having meningoencephalitis due to the local reactivation of HHV-6. Although he failed to respond to high-dose therapy with ACV (60 mg/kg/day) and gamma-globulin, the dna of this virus disappeared from the CNS upon treatment with GCV (30 mg/kg/day) combined with the intraventricular infusion of alpha-interferon. His clinical course was further complicated with meningoencephalitis due to staphylococcus epidermidis, and he died of tentorial herniation on day 79 without the recovery of blood components. This experience may indicate that intense prophylaxis to prevent reactivation of HHV-6 in the CNS is essential for the management of such profoundly immunosuppressed patients.
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ranking = 223.81254747544
keywords = encephalitis, meningoencephalitis, herpes
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4/25. Immunoglobulin synthesis in vitro by cerebrospinal fluid cells in patients with meningoencephalitis of presumed viral origin.

    cerebrospinal fluid (CSF) cells from six patients with meningoencephalitis of presumed viral origin were incubated in the presence of labeled amino acids. The cells of two of the patients synthesized IgG, IgA, and IgM (one patient) in vitro. The CSF of these two patients had an elevated level of IgG with oligoclonal distribution. The newly synthesized IgG also had an oligoclonal distribution. CSF cells of the other four patients were not shown to synthesize immunoglobulins in vitro. The CSF of these patients had a normal level of IgG with polyclonal distribution. The results demonstrate that in some patients with virus meningoencephalitis an immunoglobulin synthesis takes place locally and that at least part of the IgG shows a restricted heterogeneity. The results also suggest the presence of stimulated lymphocytes in the CSF of the same patients.
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ranking = 445.62509495087
keywords = encephalitis, meningoencephalitis
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5/25. Postinfectious myelitis, encephalitis and encephalomyelitis.

    Six cases of post-infectious encephalomyelitis are described. A preceding non-specific viral-like illness occurred 4 to 20 days before the onset of the neurological deficits. The clinical syndromes included transverse myelitis, focal encephalitis and encephalomyelitis (each in one case) and diffuse encephalitis in 3. magnetic resonance imaging appeared to be the investigation of choice. High dose corticosteroids were given to 4 patients who recovered partially or fully. The patient with focal encephalitis had a spontaneous and complete recovery. The remaining patient with diffuse encephalitis died 3 days after the onset; autopsy showed prominent lymphocytic perivascular cuffing in the white matter and lymphocytic infiltration of the meninges.
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ranking = 450.68867723368
keywords = encephalitis
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6/25. central nervous system involvement in patients with rotavirus gastroenteritis.

    Two children with rotavirus gastroenteritis are presented. The first case developed a fatal Reye's syndrome and the other one encephalitis with slow recovery. The rotavirus diagnosis was made in both cases by electron microscopy and a significant rise in antibody titres to nebraska calf diarrhea virus was seen in one of the two patients.
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ranking = 56.33608465421
keywords = encephalitis
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7/25. The separability of central auditory and cognitive deficits: implications for the elderly.

    After viral encephalitis a 40-year-old man showed both central auditory deficit and severe cognitive deficits. The asymmetric central auditory deficit was revealed by speech audiometry. The effect could be explained neither by peripheral sensitivity loss nor by cognitive status. Results highlight the separability of central auditory and cognitive deficits. Implications for the elderly are discussed.
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ranking = 56.33608465421
keywords = encephalitis
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8/25. Segmental myoclonus in a young man who had had localized encephalitis in childhood.

    A man who had had an episode of localized encephalitis, diagnosed as viral cerebellitis in childhood came to observation at the age of 23 for attacks of segmental myoclonus of the cervical axial musculature. BAEP changes at brainstem level in this case point to involvement of the Guillain-Mollaret triangle in the pathogenesis of this syndrome.
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ranking = 281.68042327105
keywords = encephalitis
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9/25. Immunological diagnosis in viral infections of the central nervous system: course of antibody titres against homo- and heterologous viruses.

    In clinical cases suspected for viral encephalitis or meningoencephalitis, the estimation of virus-specific antibodies especially in liquor requires high sensitivity as well as specificity. With enzyme immunoassays the sensitivity in detecting antibodies has increased compared to e.g., complement fixation tests. This report concerns the determination of virus-specific antibodies with a commercial enzyme-linked immunosorbent assay (ELISA) in paired liquor/serum samples of four patients with encephalitis or meningoencephalitis. Up to six virus-specific antibodies of the IgG and IgM classes have been determined [herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus, mumps virus, measles virus, and rubella virus]. Additionally, serum samples from several patients suffering, or recovered from, diseases caused by HSV and VZV without CNS involvement have been included as controls. The results showed that besides the virus-specific antibody development (IgG and IgM) against the leading virus, i.e., principally concerned in the disease manifestation assumed to be primarily causing the disease, virus-specific antibodies of the IgG and IgM class against a heterologous virus (e.g., VZV) could also be measured with substantial titers. "Cross-reacting" antibodies to both HSV and VZV with the ELISA only appeared and were present in cases where the infection mainly affected the CNS: no such immunological "cross-reactivity" was observed in serum of individuals in "clinically silent" stages of both HSV and VZV infections. The same situation with no measurable "cross-reacting" antibodies was found in cases of acute HSV or VZV diseases where the CNS was not involved. These findings have been discussed with respect to the findings of common antigens, especially between HSV and VZV, and with respect to an unspecific stimulation of immunocompetent cells.
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ranking = 262.21386762538
keywords = encephalitis, meningoencephalitis, herpes
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10/25. Benzodiazepine withdrawal delirium with catatonic features. Occurrence in patients with partial seizure disorders.

    We report the cases of 3 patients with medically intractable seizures in whom withdrawal of treatment with a long-acting benzodiazepine (clorazepate dipotassium, 2 patients; clonazepam, 1 patient) was followed by delirium with catatoniclike features. While an increase in seizure frequency occurred during withdrawal and prior to the onset of behavioral changes, electroencephalograms did not show epileptiform activity during the delirium. We compared these 3 patients with 10 others with intractable seizures in whom antiepileptic therapy was withdrawn without subsequent behavior changes. High-dose benzodiazepine therapy and a history of viral encephalitis may be risk factors for withdrawal delirium.
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ranking = 56.33608465421
keywords = encephalitis
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