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Hagel S, Brillinger N, Decker S, Deja M, Ertmer C, Fiedler S, Franken P, Heim M, Weigand MA, Zarbock A, Pletz MW. Effect of acyclovir therapy on the outcome of mechanically ventilated patients with lower respiratory tract infection and detection of herpes simplex virus in bronchoalveolar lavage: protocol for a multicentre, randomised controlled trial (HerpMV). BMJ Open 2024; 14:e082512. [PMID: 38670599 DOI: 10.1136/bmjopen-2023-082512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Herpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients and is associated with a worse outcome. The aim of this study is to determine whether antiviral therapy in HSV-positive patients improves outcome. METHODS AND ANALYSIS Prospective, multicentre, open-label, randomised, controlled trial in parallel-group design. Adult, mechanically ventilated patients with pneumonia and HSV type 1 detected in bronchoalveolar lavage (≥105 copies/mL) are eligible for participation and will be randomly allocated (1:1) to receive acyclovir (10 mg/kg body weight every 8 hours) for 10 days (or until discharge from the intensive care unit if earlier) or no intervention (control group). The primary outcome is mortality measured at day 30 after randomisation (primary endpoint) and will be analysed with Cox mixed-effects model. Secondary endpoints include ventilator-free and vasopressor-free days up to day 30. A total of 710 patients will be included in the trial. ETHICS AND DISSEMINATION The trial was approved by the responsible ethics committee and by Germany's Federal Institute for Drugs and Medical Devices. The clinical trial application was submitted under the new Clinical Trials Regulation through CTIS (The Clinical Trials Information System). In this process, only one ethics committee, whose name is unknown to the applicant, and Germany's Federal Institute for Drugs and Medical Devices are involved throughout the entire approval process. Results will be published in a journal indexed in MEDLINE and CTIS. With publication, de-identified, individual participant data will be made available to researchers. TRIAL REGISTRATION NUMBER NCT06134492.
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Affiliation(s)
- Stefan Hagel
- Friedrich Schiller University Jena, Jena, Germany
| | - Nicole Brillinger
- Center for Clinical Studies, Universitatsklinikum Jena, Jena, Thüringen, Germany
| | - Sebastian Decker
- Department of Anesthesiology, Heidelberg University, Heidelberg, Germany
| | - Maria Deja
- Department of Anesthesiology and Intensive Care Medicine, University of Schleswig-Holstein, Lübeck, Germany
| | | | | | | | - Markus Heim
- Klinikum rechts der Isar der Technischen Universitat Munchen, Munchen, Germany
| | - Markus A Weigand
- Department of Anaesthesia, UniversitatsKlinikum Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | | | - Mathias W Pletz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
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Bumburidi Y, Utepbergenova G, Yerezhepov B, Berdiyarova N, Kulzhanova K, Head J, Moffett D, Singer D, Angra P, Whistler T, Sejvar J. Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018. PLoS One 2021; 16:e0251494. [PMID: 33989305 PMCID: PMC8121361 DOI: 10.1371/journal.pone.0251494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022] Open
Abstract
Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Blood and cerebrospinal fluid (CSF) samples were collected for bacterial culture, and CSF samples were additionally tested by PCR for four bacterial species and three viruses using a cascading algorithm. We enrolled 556 patients. Of these, 494 were of viral etiology (including 4 probable rabies cases), 37 were of bacterial etiology, 19 were of unknown etiology and 6 were not tested. The most commonly identified pathogens included enterovirus (73%, n = 406 cases), herpes simplex virus (12.8%, n = 71), and Neisseria meningitidis (3.8%, n = 21). The incidence rates (IRs) for enteroviral and meningococcal EM were found to be 14.5 and 0.7 per 100,000 persons, respectively. The IR for bacterial EM using both PCR and culture results was 3–5 times higher compared to culture-only results. Antibacterial medicines were used to treat 97.2% (480/494) of virus-associated EM. Incorporation of PCR into routine laboratory diagnostics of EM improves diagnosis, pathogen identification, ensures IRs are not underestimated, and can help avoid unnecessary antibacterial treatment.
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Affiliation(s)
- Yekaterina Bumburidi
- Central Asian Regional Office, Centers for Disease Control and Prevention, Almaty, Kazakhstan
- * E-mail:
| | - Gulmira Utepbergenova
- Shymkent City Infectious Disease Hospital–Regional Department of Health Care, Southern Kazakhstan Region, Kazakhstan, Shymkent
- Department of Infectious Diseases and Phthisiatry, Khoja Akhmet Yassawi International Kazakh-Turkish University, Kazakhstan, Turkestan
| | - Bakhtygali Yerezhepov
- Shymkent City Infectious Disease Hospital–Regional Department of Health Care, Southern Kazakhstan Region, Kazakhstan, Shymkent
| | - Nursulu Berdiyarova
- Shymkent City Infectious Disease Hospital–Regional Department of Health Care, Southern Kazakhstan Region, Kazakhstan, Shymkent
| | - Kaldikul Kulzhanova
- Shymkent City Infectious Disease Hospital–Regional Department of Health Care, Southern Kazakhstan Region, Kazakhstan, Shymkent
| | - Jennifer Head
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- Public Health Institute, Oakland, CA, United States of America
- Association of Schools and Programs of Public Health, Washington DC, United States of America
| | - Daphne Moffett
- Central Asian Regional Office, Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Daniel Singer
- Central Asian Regional Office, Centers for Disease Control and Prevention, Almaty, Kazakhstan
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Pawan Angra
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Toni Whistler
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - James Sejvar
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Karimi-Boroujeni M, Zahedi-Amiri A, Coombs KM. Embryonic Origins of Virus-Induced Hearing Loss: Overview of Molecular Etiology. Viruses 2021; 13:71. [PMID: 33419104 PMCID: PMC7825458 DOI: 10.3390/v13010071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022] Open
Abstract
Hearing loss, one of the most prevalent chronic health conditions, affects around half a billion people worldwide, including 34 million children. The World Health Organization estimates that the prevalence of disabling hearing loss will increase to over 900 million people by 2050. Many cases of congenital hearing loss are triggered by viral infections during different stages of pregnancy. However, the molecular mechanisms by which viruses induce hearing loss are not sufficiently explored, especially cases that are of embryonic origins. The present review first describes the cellular and molecular characteristics of the auditory system development at early stages of embryogenesis. These developmental hallmarks, which initiate upon axial specification of the otic placode as the primary root of the inner ear morphogenesis, involve the stage-specific regulation of several molecules and pathways, such as retinoic acid signaling, Sonic hedgehog, and Wnt. Different RNA and DNA viruses contributing to congenital and acquired hearing loss are then discussed in terms of their potential effects on the expression of molecules that control the formation of the auditory and vestibular compartments following otic vesicle differentiation. Among these viruses, cytomegalovirus and herpes simplex virus appear to have the most effect upon initial molecular determinants of inner ear development. Moreover, of the molecules governing the inner ear development at initial stages, SOX2, FGFR3, and CDKN1B are more affected by viruses causing either congenital or acquired hearing loss. Abnormalities in the function or expression of these molecules influence processes like cochlear development and production of inner ear hair and supporting cells. Nevertheless, because most of such virus-host interactions were studied in unrelated tissues, further validations are needed to confirm whether these viruses can mediate the same effects in physiologically relevant models simulating otic vesicle specification and growth.
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Affiliation(s)
- Maryam Karimi-Boroujeni
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Ali Zahedi-Amiri
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
| | - Kevin M. Coombs
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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Diezma-Martín AM, Gigante-Miravalles E, Castro Limo JD, Quimbayo Arcila CA, Puche Paniagua JJ. Herpetic esophagitis in immunocompentent host: cases report. BMC Infect Dis 2020; 20:605. [PMID: 32807089 PMCID: PMC7433066 DOI: 10.1186/s12879-020-05328-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/05/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Herpetic esophagitis (EH) usually affects those who are immunocompromised and is uncommon in immunocompetent patients. In these cases, EH may occasionally present as an acute and self-limited illness. Such cases are rare and only a few have beenreported and limited published reviews exist making the benefits of antiviral therapy in immunocompetent patients unknown. CASE PRESENTATION We report four cases of young patients who presented dysphagia, odynophagia and epigastric pain. Endoscopic findings revealed lesions in the distal esophagus and histopathological changes compatible with herpes virus infection confirmed by viral DNA in every case. After treatment, every patient showed significant improvement and tolerated oral intake after discharge. CONCLUSIONS In this publication, we present four immunocompetent patients with EH, without relevant alterations in laboratory workup and with negative HIV status. This disease is infrequent in patients with such characteristics and there are few cases published. In order to better understand this pathology, we present the symptoms, the endoscopic alterations and the clinical evolution with treatment. In our series, 50% of patients had serology compatible with acute HVS type 1 infection, 25% had a subacute infection pattern (IgM and IgG positive antibodies) and in another 25% of patients, serology was not done. No patient presented leukocyte alterations, while all patients presented with anatomopathological findings compatible with acute herpetic esophagitis and responded to acyclovir therapy.
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5
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Kogawa S, Oi J, Hashi M. [A case of herpes simplex virus encephalitis recurring after a seven-year interval]. Rinsho Shinkeigaku 2020; 60:461-465. [PMID: 32536661 DOI: 10.5692/clinicalneurol.60.cn-001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In January 2008, a 59-year-old man with a history of diabetes mellitus was admitted to our hospital with herpes simplex virus (HSV) encephalitis of his right temporal lobe, which was diagnosed by PCR testing of his cerebrospinal fluid (CSF). He was treated with intravenous acyclovir for three weeks and made a full recovery. On discharge, his CSF was negative for HSV on PCR testing. Seven years later, in March 2015, the man was readmitted to our hospital with fever, disorientation, and nominal dysphasia. Diffusion-weighted MRI of his head revealed a high-intensity area in his left temporal lobe. Testing of his CSF revealed a moderately increased monocyte count and HSV on PCR testing, so he was diagnosed with recurrent HSV encephalitis. He was treated with intravenous acyclovir for three weeks. On discharge, his CSF was negative for HSV on PCR testing, but he had mild residual amnesia. There have been few reports of HSV encephalitis with viral reactivation recurring after a long remission period in adults. This case illustrates the need for prolonged follow up of individuals with HSV encephalitis in order to detect recurrences.
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Affiliation(s)
- Shuro Kogawa
- Department of Internal Medicine, Kohka Public Hospital
| | - Jiro Oi
- Department of Internal Medicine, Kohka Public Hospital
| | - Makiko Hashi
- Department of Internal Medicine, Kohka Public Hospital
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Abstract
INTRODUCTION Hyaluronic acid injections is relatively safe with little risk of complications. Although herpes reactivation after the injection of hyaluronic acid is rare, it produces quite a huge pressure and panic on patients. Quite a lot cosmetic practitioners have no awareness of preventing, diagnosing, and giving correct treatment in time due to lack of experience. PATIENT CONCERNS A 24-year-old woman presented with erythema, crusted papules, pain and swelling on the nose after receiving the injection of hyaluronic acid. A swab of the discharge fluid was obtained for bacterial and viral culture, showing positive for herpes simplex virus. DIAGNOSIS The patient was diagnosed as herpes reactivation after the injection of hyaluronic acid. INTERVENTIONS The patient underwent antiviral therapy with acyclovir 400 mg, 3 times daily for seven days. OUTCOMES After a week of antiviral treatment, the clinical signs improved. CONCLUSION Herpes reactivation after the injection of hyaluronic acid is quite rare but needed sufficient attention of cosmetic practitioners to make the proper diagnosis, prevention and treatment.
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Affiliation(s)
- Chenyu Wang
- Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Tianyu Sun
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK
| | - Nanze Yu
- Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xiaojun Wang
- Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
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7
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McEwen MW, Wang AL. Recurrent vesicles on the palm. Cutis 2020; 105:117-122. [PMID: 32352434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Matthew W McEwen
- Department of Dermatology, University of Tennessee Health Science Center, Memphis, USA
| | - Apphia L Wang
- Department of Dermatology, University of Alabama at Birmingham, USA
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Liu Y, Wu Y, Wang F, Wang S, Zhao W, Chen L, Tu S, Qian Y, Liao Y, Huang Y, Zhang R, Xu G, Zhang D. The Association Between Previous TORCH Infections and Pregnancy and Neonatal Outcomes in IVF/ICSI-ET: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2020; 11:466. [PMID: 32849269 PMCID: PMC7419419 DOI: 10.3389/fendo.2020.00466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 06/15/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to investigate the associations between previous TORCH infection (cytomegalovirus, toxoplasmosis, herpes simplex virus, and rubella) with pregnancy and neonatal outcomes in couples undergoing IVF/ICSI-ET. Materials and Methods: A total of 18,074 couples underwent fresh IVF/ICSI-ET (in vitro fertilization/intracytoplasmic sperm injection-embryo transfer) cycles were included in our analyses. TORCH infection status was determined by serological confirmation of cytomegalovirus, toxoplasmosis, herpes simplex virus, and rubella IgG in the absence of IgM antibodies. Clinical pregnancy, ectopic pregnancy, miscarriage, live birth, preterm birth, congenital malformation, and perinatal death were evaluated in both infection and non-infection group. Multivariate logistic regression was applied to calculate odds ratio. Results: Previous toxoplasmosis infection is associated with a significantly decreased preterm birth rate [P = 0.045, OR = 0.755 (95% CI, 0.571-0.997), Adjusted OR = 0.749 (95%CI, 0.566-0.991)]. No differences in clinical pregnancy, ectopic pregnancy, miscarriage, and perinatal death were observed between the corresponding TORCH infection group [IgM (-) IgG(+)] and the non-infection group [IgM (-) IgG (-)]. Conclusions: Previous TORCH infections were not associated with adverse pregnancy and neonatal outcomes in IVF/ICSI-ET overall, and toxoplasmosis infection might be associated with a lower preterm birth rate in patients underwent IVF/ICSI-ET. The necessity of TORCH IgG screening in IVF procedure might need re-evaluation, and further cost-effective analysis might be helpful for the clinical management strategy.
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Affiliation(s)
- Yifeng Liu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yiqing Wu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Feixia Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Siwen Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Wei Zhao
- Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Hangzhou, China
| | - Lifen Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Shijiong Tu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yuli Qian
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yun Liao
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yun Huang
- Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Hangzhou, China
| | - Runjv Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Gufeng Xu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Gufeng Xu
| | - Dan Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Hangzhou, China
- *Correspondence: Dan Zhang
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Affiliation(s)
- T Iida
- Department of Gastroenterology, Otaru City General Hospital, Otaru, Japan and Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - H Nakase
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Steadman L, Hrynewycz K, Grove DC, Haggstrom A. Seborrhea herpeticum: cutaneous herpes simplex virus infection within infantile seborrheic dermatitis. Cutis 2019; 104:295-296. [PMID: 31886781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Eczema herpeticum has been well described in the setting of atopic dermatitis (AD) and other dermatoses. We present the case of a 2-month-old infant boy with cutaneous herpes simplex virus (HSV) infection within existing diffuse infantile seborrheic dermatitis. Providers should be aware that cutaneous HSV can be confined to a seborrheic distribution and may represent underlying epidermal dysfunction secondary to seborrheic dermatitis.
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Affiliation(s)
| | - Katherine Hrynewycz
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
| | - Daniel C Grove
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
| | - Anita Haggstrom
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, USA
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11
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Aronson PL, Cruz AT, Freedman SB, Balamuth F, Grether-Jones KL, Lyons TW, Fleming AH, Louie J, Mistry RD, Garro AC, Shah SS, Nigrovic LE. Association of Herpes Simplex Virus Testing with Hospital Length of Stay for Infants ≤60 Days of Age Undergoing Evaluation for Meningitis. J Hosp Med 2019; 14:492-495. [PMID: 31112493 PMCID: PMC6686736 DOI: 10.12788/jhm.3202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although neonatal herpes simplex virus (HSV) causes significant morbidity, utilization of the cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) test remains variable. Our objective was to examine the association of CSF HSV PCR testing with length of stay (LOS) in a 20-center retrospective cohort of hospitalized infants aged ≤60 days undergoing evaluation for meningitis after adjustment for patient-level factors and clustering by center. Of 20,496 eligible infants, 7,399 (36.1%) had a CSF HSV PCR test performed, and 46 (0.6% of those tested) had a positive test. Infants who had a CSF HSV PCR test performed had a 23% longer hospital LOS (incident rate ratio 1.23; 95% CI: 1.14-1.33). Targeted CSF HSV PCR testing may mitigate the impact on LOS for low-risk infants.
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Affiliation(s)
- Paul L Aronson
- Section of Pediatric Emergency Medicine, Departments of Pediatrics and of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
- Corresponding Author: Paul L Aronson, MD, MHS; E-mail: ; Telephone: 203-785-3849
| | - Andrea T Cruz
- Sections of Pediatric Emergency Medicine and of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Stephen B Freedman
- Sections of Pediatric Emergency Medicine and Gastroenterology, Department of Pediatrics, Alberta Children’s Hospital, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Fran Balamuth
- Division of Emergency Medicine
- Center for Pediatric Clinical Effectiveness, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kendra L Grether-Jones
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California
| | - Todd W Lyons
- Division of Emergency Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alesia H Fleming
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Jeffrey Louie
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota
| | - Rakesh D Mistry
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Aris C Garro
- Section of Emergency Medicine, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Samir S Shah
- Divisions of Infectious Diseases
- Hospital Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lise E Nigrovic
- Division of Emergency Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
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12
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Affiliation(s)
- Jacob D Soumerai
- From the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Shahein H Tajmir
- From the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Martin S Hirsch
- From the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Harvard Medical School - both in Boston
| | - Lucas R Massoth
- From the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Massachusetts General Hospital, and the Departments of Medicine (J.D.S., M.S.H.), Radiology (S.H.T.), and Pathology (L.R.M.), Harvard Medical School - both in Boston
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13
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Kimberlin DW. The Tail Wagging the Dog (or the Challenges Faced When the Financing of Medicine Gets Ahead of the Science of Medicine). J Clin Microbiol 2018; 56:e00904-18. [PMID: 30021827 PMCID: PMC6156319 DOI: 10.1128/jcm.00904-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In their article in this issue of the Journal of Clinical Microbiology, S. R. Dominguez et al. (J Clin Microbiol 56:e00632-18, 2018, https://doi.org/10.1128/JCM.00632-18) describe the performance of PCR detection of herpes simplex virus (HSV) DNA versus viral culture in skin and mucosal samples from 7 neonates with HSV disease. This is a significant contribution to our understanding of the optimal diagnostic approach in babies being evaluated for neonatal HSV disease. Many diagnostic laboratories already have made the change to molecular diagnostics for skin and mucosal swab testing, however, in large part due to the labor costs associated with viral cultures. Thus, important studies such as this one are being conducted to support a decision that has already been made in many locations on mostly economic grounds. This small case series supports the decision to use molecular testing for samples from skin and mucosal sites, but larger studies are needed to more fully define the performance characteristics of PCR in this population. Since a false-positive result would commit a baby to months of management that would be unnecessary and have potential harm, it is critical to base diagnostic decision making on data that support the use of a specific test.
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Affiliation(s)
- David W Kimberlin
- Division of Pediatric Infectious Diseases, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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14
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Vestergaard T. [Genital herpes]. Ugeskr Laeger 2018; 180:V01180024. [PMID: 29798750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Genital herpes is a common sexually transmissible infection (STI) caused by herpes simplex virus (HSV). Clinically, the infection presents with genital ulcers but may also be asymptomatic. The risk of genital HSV infection is associated with increasing number of sex partners, previous infection with another STI and female sex. The cornerstone of treatment is systemic antivirals such as acyclovir. Counselling on transmission and recurrence risks is essential, and psychological distress is often a consequence of the disease.
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Abstract
A spindle-cell carcinoma developed on the lower lip of 53-year-old patient who had suffered from recurrent local herpes. From a tumor biopsy a human herpesvirus 1 (Type 1 Herpes Simplex Virus) was isolated (strain n. 466). Infected cells contain eosinophilic intranuclear inclusions (fig. 3); the agent's cpe is abolished by anti-HSV antiserum and by chloroform; the agent produces typical plaques (fig. 4), grows at 38 °C, and its DNA has a density of approximately 1.726 g per cm3, equal to that of DNA of « F » prototype of human herpesvirus 1 (text-fig. 1). However, its immunological structure (text-fig. 2) and its protein electrophoretic pattern (fig. 5) slightly differentiate this virus from homotypic strains including some local isolates. At the time the virus was isolated from the tumor no HSV was recovered from the surrounding skin of the patient. After surgical removal of the tumor, the patient suffered no more of herpetic recurrences. As far as the significance of the isolation is concerned, UV-inactivated strains possess a transforming activity in vitro and human herpesvirus 2 is known to be associated to cervical carcinoma in some human populations, but no direct oncogenicity has been shown in HSV. In our case, HSV may have been implicated through the association of the irritant effect of repeated recurrences and a possible abortive type of infection with cigarette smoking.
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Menarini L, Terni M, Pavanelli C, Tortora M. Comparative in Vitro Titrations of Herpes Simplex Virus in Cells Derived from Normal Uterine Cervix and from Cervical Cancer. Tumori 2018; 59:25-32. [PMID: 4350736 DOI: 10.1177/030089167305900103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sero-epidemiologic investigations showed a significant association between carcinoma of the cervix uteri and previous infections of the female genital tract with subtype 2, or genital, Herpes Simplex Virus (HSV-2) (ref. 3, 13, 14, 16). This association could be due to a carcinogenic, or co-carcinogenic effect of HSV (ref. 6 and 17), or else to a preferential viral growth in tumoral or transformed cells as against normal cells. To test the latter hypothesis we cultured in vitro cells from normal cervix and from cervical cancer, and assayed HSV-2 (and also HSV-1, or facial, and the MP mutant of HSV-1: ref. 9, 12) in our cell cultures as well as in the human HEp-2 cell line. Equivalent viral yields (results not reported in detail), equivalent numbers of viral plaques (table 1) and similar plaque morphology (fig.8) and intracellular ecp (fig.7) were observed in our cell cultures and in HEp-2 cells. Thus, a preferential viral growth in tumoral cells is not apparent.
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17
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Kularatne RS, Muller EE, Maseko DV, Kufa-Chakezha T, Lewis DA. Trends in the relative prevalence of genital ulcer disease pathogens and association with HIV infection in Johannesburg, South Africa, 2007-2015. PLoS One 2018; 13:e0194125. [PMID: 29617372 PMCID: PMC5884493 DOI: 10.1371/journal.pone.0194125] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 02/26/2018] [Indexed: 01/08/2023] Open
Abstract
Background In South Africa, treatment of genital ulcer disease (GUD) occurs in the context of syndromic management. GUD aetiological studies have been conducted in Johannesburg since 2007. We report on GUD pathogen prevalence, sero-prevalence of STI co-infections and aetiological trends among GUD patients presenting to a community-based primary healthcare facility in Johannesburg over a 9-year period. Methods and findings GUD surveys were conducted from January to April each year. Consecutive genital ulcers were sampled from consenting adults. Swab-extracted DNA was tested by multiplex real-time PCR assays for herpes simplex virus (HSV), Treponema pallidum (TP), Haemophilus ducreyi (HD) and Chlamydia trachomatis (CT). HSV-positive DNA extracts were further subtyped into HSV-1 and HSV-2 using a commercial PCR assay; CT-positive extracts were tested with an in-house PCR assay specific for serovars L1-L3 (lymphogranuloma venereum). Sera were tested for HIV, HSV-2, and syphilis co-infections. Giemsa-stained ulcer smears were screened for Klebsiella granulomatis by microscopy. Data were analysed with STATATM version 14. Of 771 GUD specimens, 503 (65.2%) had a detectable pathogen: HSV 468 (60.7%); TP 30 (3.9%); CT L1-3 7 (0.9%); HD 4 (0.5%). No aetiological agents were detected in 270 (34.8%) ulcer specimens. Seroprevalence rates were as follows: HIV 61.7%; HSV-2 80.2% and syphilis 5.8%. There was a strong association between GUD pathogen detection and HIV seropositivity (p < 0.001); 68% of cases caused by HSV were co-infected with HIV. There was a significant decline in the relative prevalence of ulcer-derived HSV over time, predominantly from 2013–2015 (p-value for trend = 0.023); and a trend towards a decrease in the HIV seropositivity rate (p-value for trend = 0.209). Conclusions HSV remains the leading cause of pathogen-detectable GUD in South Africa. The prevalence of HIV co-infection among GUD patients is high, underlining the importance of linkage to universal HIV testing and treatment in primary healthcare settings.
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Affiliation(s)
- Ranmini S. Kularatne
- Centre for HIV & STIs, National Institute for Communicable Diseases, Johannesburg, South Africa
- Department of Clinical Microbiology & Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Etienne E. Muller
- Centre for HIV & STIs, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Dumisile V. Maseko
- Centre for HIV & STIs, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Tendesayi Kufa-Chakezha
- Centre for HIV & STIs, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - David A. Lewis
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Sydney, Australia
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18
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Wen L, Qiu Y, Cheng S, Jiang X, Ma YP, Fang W, Wang W, Cui J, Ruan Q, Zhao F, Hu F, Luo MH. Serologic and viral genome prevalence of HSV, EBV, and HCMV among healthy adults in Wuhan, China. J Med Virol 2018; 90:571-581. [PMID: 29091300 DOI: 10.1002/jmv.24989] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/28/2017] [Indexed: 12/27/2022]
Abstract
The worldwide infection rate of herpesvirus is high, but the detailed prevalence in China, especially the central area, remains unclear. In the present study, the prevalence of herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human cytomegalovirus (HCMV) was investigated in 303 healthy adults in Wuhan, a representative city in Central China. Viral-specific IgG and IgM titers were examined in the serum by chemiluminescent immunoassay, and the existence of viral genomic DNA in blood cells was determined by nested PCR. The overall IgG seroprevalences were 81.5%, 95.4%, and 93.7% for HSV, EBV, and HCMV, while the corresponding IgM seroprevalences were only 6.3%, 2.3%, and 0. The viral genomic DNA of HSV, EBV, and HCMV was identified in the blood samples of 5.9%, 14.2%, and 22.8% of the tested donors, respectively. Significantly, less HSV IgM-positive samples were found in the population over 20 years old than below 20 group; female displayed higher chances for HSV IgG and genome positivity; and occupations such as waiters and medical staffs were shown to be with higher risk for HCMV genome positivity. This study provided useful reference data for the HSV, EBV, and HCMV prevalence in central China, and suggested the potential importance of detecting viral genome to complement serum test data.
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Affiliation(s)
- Le Wen
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yong Qiu
- Wuhan Brain Hospital, Ministry of Transportation, Wuhan, China
| | - Shuang Cheng
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Xuan Jiang
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children Medical Center, Guangzhou, China
| | - Yan-Ping Ma
- Virus Laboratory, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China
| | - Wei Fang
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Wei Wang
- The Third Xiangya Hospital, South Central University, Changsha, China
| | - Jie Cui
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Qiang Ruan
- Virus Laboratory, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China
| | - Fei Zhao
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Fei Hu
- Wuhan Brain Hospital, Ministry of Transportation, Wuhan, China
| | - Min-Hua Luo
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children Medical Center, Guangzhou, China
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19
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Hoeksema L, Jansonius NM, Los LI. Risk Factors for Secondary Glaucoma in Herpetic Anterior Uveitis. Am J Ophthalmol 2017; 181:55-60. [PMID: 28666730 DOI: 10.1016/j.ajo.2017.06.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine the incidence of elevated intraocular pressure (IOP) and secondary glaucoma in herpetic anterior uveitis (AU), owing to either herpes simplex or varicella zoster virus, by using the Standardization of Uveitis Nomenclature (SUN) criteria, and to identify risk factors for the development of glaucoma. DESIGN Retrospective observational cohort study. METHODS Patients with herpetic AU presenting themselves between 2001 and 2013 at the ophthalmology department of the University Medical Center Groningen were included. Main outcome measures were the incidence of elevated IOP and glaucoma and risk factors for the development of glaucoma. RESULTS Seventy-three herpetic AU patients were included. Ocular complications most commonly seen during follow-up for uveitis were elevated IOP (75%), keratitis (59%), dry eyes (34%), posterior synechiae (34%), cataract (32%), and glaucoma (15%). Glaucoma patients, in comparison to non-glaucoma patients, had a higher number of IOP peaks during their follow-up for uveitis (P < .001). The majority of patients with elevated IOP (91%) had this already at the start of the uveitis. Nineteen percent of the patients needed glaucoma surgery. CONCLUSIONS Using the SUN criteria, our study confirmed that elevated IOP and secondary glaucoma are major complications in herpetic AU. If an elevated IOP occurred, it was usually already present at the start of a uveitis episode. A risk factor for the development of glaucoma was the number of endured IOP peaks. Future studies are needed to evaluate whether early and prolonged use of antiviral and IOP-lowering medication may prevent glaucoma.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Viral/blood
- Child
- Child, Preschool
- Cohort Studies
- DNA, Viral/genetics
- Eye Infections, Viral/virology
- Female
- Glaucoma/epidemiology
- Glaucoma/etiology
- Herpes Zoster Ophthalmicus/virology
- Herpesvirus 3, Human/genetics
- Herpesvirus 3, Human/immunology
- Herpesvirus 3, Human/isolation & purification
- Humans
- Incidence
- Intraocular Pressure
- Keratitis, Herpetic/virology
- Male
- Middle Aged
- Polymerase Chain Reaction
- Retrospective Studies
- Risk Factors
- Simplexvirus/genetics
- Simplexvirus/immunology
- Simplexvirus/isolation & purification
- Tonometry, Ocular
- Uveitis, Anterior/virology
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Affiliation(s)
- Lisette Hoeksema
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands.
| | - Nomdo M Jansonius
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
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20
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Morse AM, Calabro KR, Fear JM, Bloom DC, McIntyre LM. Reliable Detection of Herpes Simplex Virus Sequence Variation by High-Throughput Resequencing. Viruses 2017; 9:v9080226. [PMID: 28812996 PMCID: PMC5580483 DOI: 10.3390/v9080226] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/14/2017] [Accepted: 08/09/2017] [Indexed: 12/13/2022] Open
Abstract
High-throughput sequencing (HTS) has resulted in data for a number of herpes simplex virus (HSV) laboratory strains and clinical isolates. The knowledge of these sequences has been critical for investigating viral pathogenicity. However, the assembly of complete herpesviral genomes, including HSV, is complicated due to the existence of large repeat regions and arrays of smaller reiterated sequences that are commonly found in these genomes. In addition, the inherent genetic variation in populations of isolates for viruses and other microorganisms presents an additional challenge to many existing HTS sequence assembly pipelines. Here, we evaluate two approaches for the identification of genetic variants in HSV1 strains using Illumina short read sequencing data. The first, a reference-based approach, identifies variants from reads aligned to a reference sequence and the second, a de novo assembly approach, identifies variants from reads aligned to de novo assembled consensus sequences. Of critical importance for both approaches is the reduction in the number of low complexity regions through the construction of a non-redundant reference genome. We compared variants identified in the two methods. Our results indicate that approximately 85% of variants are identified regardless of the approach. The reference-based approach to variant discovery captures an additional 15% representing variants divergent from the HSV1 reference possibly due to viral passage. Reference-based approaches are significantly less labor-intensive and identify variants across the genome where de novo assembly-based approaches are limited to regions where contigs have been successfully assembled. In addition, regions of poor quality assembly can lead to false variant identification in de novo consensus sequences. For viruses with a well-assembled reference genome, a reference-based approach is recommended.
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Affiliation(s)
- Alison M Morse
- University of Florida Genetics Institute, Department of Molecular Genetics & Microbiology, University of Florida College of Medicine, Gainesville, FL 32611, USA.
| | - Kaitlyn R Calabro
- University of Florida Genetics Institute, Department of Molecular Genetics & Microbiology, University of Florida College of Medicine, Gainesville, FL 32611, USA.
| | - Justin M Fear
- University of Florida Genetics Institute, Department of Molecular Genetics & Microbiology, University of Florida College of Medicine, Gainesville, FL 32611, USA.
| | - David C Bloom
- University of Florida Genetics Institute, Department of Molecular Genetics & Microbiology, University of Florida College of Medicine, Gainesville, FL 32611, USA.
| | - Lauren M McIntyre
- University of Florida Genetics Institute, Department of Molecular Genetics & Microbiology, University of Florida College of Medicine, Gainesville, FL 32611, USA.
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21
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Eberle R, Maxwell LK, Nicholson S, Black D, Jones-Engel L. Genome sequence variation among isolates of monkey B virus (Macacine alphaherpesvirus 1) from captive macaques. Virology 2017; 508:26-35. [PMID: 28494342 PMCID: PMC5535784 DOI: 10.1016/j.virol.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/17/2017] [Accepted: 05/02/2017] [Indexed: 12/15/2022]
Abstract
Complete genome sequences of 19 strains of monkey B virus (Macacine alphaherpesvirus 1; BV) isolated from several macaque species were determined. A low level of sequence variation was present among BV isolates from rhesus macaques. Most variation among BV strains isolated from rhesus macaques was located in regions of repetitive or quasi-repetitive sequence. Variation in coding sequences (polypeptides and miRNAs) was minor compared to regions of non-coding sequences. Non-coding sequences in the long and short repeat regions of the genome did however exhibit islands of conserved sequence. Oral and genital isolates from a single monkey were identical in sequence and varied only in the number of iterations of repeat units in several areas of repeats. Sequence variation between BV isolates from different macaque species (different BV genotypes) was much greater and was spread across the entire genome, confirming the existence of different genotypes of BV in different macaque species.
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Affiliation(s)
- R Eberle
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA.
| | - L K Maxwell
- Department of Physiological Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - S Nicholson
- Department of Biochemistry and Molecular Biology, College of Agriculture Sciences and Natural Resources, Oklahoma State University, Stillwater, OK, USA
| | - D Black
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - L Jones-Engel
- Department of Anthropology, University of Washington, Seattle, WA, USA
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22
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Joshi VM, Bhat KG, Kugaji MS, Shirahatti R. Characterization and serotype distribution of Aggregatibacter actinomycetemcomitans: Relationship of serotypes to herpesvirus and periodontal status in Indian subjects. Microb Pathog 2017; 110:189-195. [PMID: 28668607 DOI: 10.1016/j.micpath.2017.06.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/25/2017] [Accepted: 06/26/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND The virulence of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) in any individual depends on the type of strain of this bacterium. To our knowledge, there have been no studies reported in Indian subjects about A. actinomycetemcomitans serotype occurrence, co-existence with herpes virus and the possible influence of such co-existence on periodontal pathology. METHODS Subjects for this study were a subset of a larger study to identify the prevalence of A. actinomycetemcomitans in chronic periodontitis. A total of 63 subjects (12 periodontally healthy and 51 with chronic periodontitis) who were positive for A. actinomycetemcomitans were serotyped for strain-level identification. The presence of Human Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) was tested in subgingival plaque samples by polymerase chain reaction. RESULTS All five serotypes a to e were detected. Of the samples analyzed 38.09% harbored a single serotype, 36.5% had two serotypes, 6.3% demonstrated three and 4.7% demonstrated four serotypes. None of the samples showed presence of JP2 strain. Serotypes b, c, and e were most frequently identified in these individuals (46.03%, 36.5% and 38.09% respectively). Presence of serotypes b and c and absence of serotype d was associated with increased PD and CAL. Among 63 samples analyzed, 11 samples had CMV, four samples had EBV and nine samples had both these viruses. The PD and CAL were significantly higher (p = 0.04) when a combination of CMV and one of the serotypes was present indicating a pathological role of the coexistence. CONCLUSION Multiple serotypes are associated with chronic periodontitis in Indians, however, JP2 strains are not detectable in this cohort. Presence of multiple serotypes and a combination of any serotype with herpesvirus is associated with greater severity of the disease.
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Affiliation(s)
- Vinayak M Joshi
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences & Research Centre, Belagavi, Karnataka, India.
| | - Kishore G Bhat
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences & Research Centre, Belagavi, Karnataka, India
| | - Manohar S Kugaji
- Central Research Laboratory, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences & Research Centre, Belagavi, Karnataka, India
| | - Ravi Shirahatti
- Department of Public Health Dentistry, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences & Research Centre, Belagavi, Karnataka, India
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23
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Khumalo J, Nicol M, Hardie D, Muloiwa R, Mteshana P, Bamford C. Diagnostic accuracy of two multiplex real-time polymerase chain reaction assays for the diagnosis of meningitis in children in a resource-limited setting. PLoS One 2017; 12:e0173948. [PMID: 28346504 PMCID: PMC5367690 DOI: 10.1371/journal.pone.0173948] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/01/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Accurate etiological diagnosis of meningitis is important, but difficult in resource-limited settings due to prior administration of antibiotics and lack of viral diagnostics. We aimed to develop and validate 2 real-time multiplex PCR (RT-PCR) assays for the detection of common causes of community-acquired bacterial and viral meningitis in South African children. METHODS We developed 2 multiplex RT- PCRs for detection of S. pneumoniae, N. meningitidis, H. influenzae, enteroviruses, mumps virus and herpes simplex virus. We tested residual CSF samples from children presenting to a local paediatric hospital over a one-year period, whose CSF showed an abnormal cell count. Results were compared with routine diagnostic tests and the final discharge diagnosis. We calculated accuracy of the bacterial RT-PCR assay compared to CSF culture and using World Health Organisation definitions of laboratory-confirmed bacterial meningitis. RESULTS From 292 samples, bacterial DNA was detected in 12 (4.1%) and viral nucleic acids in 94 (32%). Compared to CSF culture, the sensitivity and specificity of the bacterial RT-PCR was 100% and 97.2% with complete agreement in organism identification. None of the cases positive by viral RT-PCR had a bacterial cause confirmed on CSF culture. Only 9/90 (10%) of patients diagnosed clinically as bacterial meningitis or partially treated bacterial meningitis tested positive with the bacterial RT-PCR. DISCUSSION In this population the use of 2 multiplex RT-PCRs targeting 6 common pathogens gave promising results. If introduced into routine diagnostic testing, these multiplex RT-PCR assays would supplement other diagnostic tests, and have the potential to limit unnecessary antibiotic therapy and hospitalisation.
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MESH Headings
- Bacteria/genetics
- Bacteria/isolation & purification
- Child
- Child, Preschool
- DNA, Bacterial/genetics
- DNA, Bacterial/isolation & purification
- Enterovirus/genetics
- Enterovirus/isolation & purification
- Female
- Haemophilus influenzae/genetics
- Haemophilus influenzae/isolation & purification
- Humans
- Male
- Meningitis, Bacterial/cerebrospinal fluid
- Meningitis, Bacterial/diagnosis
- Meningitis, Bacterial/epidemiology
- Meningitis, Bacterial/microbiology
- Meningitis, Viral/cerebrospinal fluid
- Meningitis, Viral/diagnosis
- Meningitis, Viral/epidemiology
- Meningitis, Viral/virology
- Multiplex Polymerase Chain Reaction/methods
- Mumps virus/genetics
- Mumps virus/isolation & purification
- Neisseria meningitidis/genetics
- Neisseria meningitidis/isolation & purification
- Nucleic Acids/genetics
- Nucleic Acids/isolation & purification
- Sensitivity and Specificity
- Simplexvirus/genetics
- Simplexvirus/isolation & purification
- South Africa
- Streptococcus pneumoniae/genetics
- Streptococcus pneumoniae/isolation & purification
- Viruses/genetics
- Viruses/isolation & purification
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Affiliation(s)
- Jermaine Khumalo
- Division of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Mark Nicol
- Division of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Diana Hardie
- National Health Laboratory Service, Johannesburg, South Africa
- Division of Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Rudzani Muloiwa
- Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - Phindile Mteshana
- Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - Colleen Bamford
- Division of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, Johannesburg, South Africa
- * E-mail:
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24
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Alimbarova LM, Lazarenko AA, Lvov ND, Barinsky IF. [THE SPECTRUM OF MARKERS OF HERPES VIRAL INFECTIONS AND ALGORITHM OF THEIR LABORATORY DIAGNOSTIC IN CHILDREN WITH INFLAMMATORY PROCESSES OF UPPER RESPIRATORY WAYS AND ENT-ORGANS]. Klin Lab Diagn 2017; 62:182-188. [PMID: 30620536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The purpose of study is to explore markers of persistent herpes viral infections in children with inflammatory processes of upper respiratory ways and ENT-organs. The sampling included 118 examined patients aged from 1 month to 17 years. The complex of standardized viral, immunological, molecular genetic methods was applied to detect (to exclude) herpes infection: cytomegalovirus infection, Epstein-Barre virus infection, simplex herpes virus infection. The diagnostic algorithm of examination of children with diseases of upper respiratory ways for herpes infection is presented. The dominating significance of simplex herpes virus and Epstein-Barre virus and also Staphylococcus aureus and Streptococcus haemolyticus-β group A at the analysis of microbial landscape. In 83.9% of children with diseases of upper respiratory ways chronic infections of simplex herpes virus, Epstein-Barre virus, cytomegalovirus; in39.39% - mixed-infection; in 41.03% - combination of simplex herpes virus and Epstein-Barre virus infections; in 33.33% - combination of simplex herpes virus and cytomegalovirus infections; in 7.69% - combination of simplex herpes virus and Epstein-Barre virus and cytomegalovirus infections; in 17.94% - combination of Epstein-Barre virus and cytomegalovirus infections; The particularity of course of persistent herpes infection in children had to do with absence of specific symptoms of nosologic form in 59.2% of cases. The results of analysis of smears from nasopharynx of children infected with herpes viruses permitted to detect: Staphylococcus aureus in 36.36%; Streptococcus haemolyticus-β in 32.32%; Streptococcus haemolyticus-α in 11.11%; Candida albicans of mucous membranes in 4.04% of children. The viral bacterial mixed-infection was detected in 44.44%. The laboratory signs of activity of immune inflammation were detected: increasing of content of TNАα and decreasing of level of IFNγ. The results of study substantiate necessity of individual approach to therapy of children with diseases of upper respiratory ways and ENT-organs and with implementation of complex of curative rehabilitating activities.The purpose of study is to explore markers of persistent herpes viral infections in children with inflammatory processes of upper respiratory ways and ENT-organs. The sampling included 118 examined patients aged from 1 month to 17 years. The complex of standardized viral, immunological, molecular genetic methods was applied to detect (to exclude) herpes infection: cytomegalovirus infection, Epstein-Barre virus infection, simplex herpes virus infection. The diagnostic algorithm of examination of children with diseases of upper respiratory ways for herpes infection is presented. The dominating significance of simplex herpes virus and Epstein-Barre virus and also Staphylococcus aureus and Streptococcus haemolyticus-β group A at the analysis of microbial landscape. In 83.9% of children with diseases of upper respiratory ways chronic infections of simplex herpes virus, Epstein-Barre virus, cytomegalovirus; in39.39% - mixed-infection; in 41.03% - combination of simplex herpes virus and Epstein-Barre virus infections; in 33.33% - combination of simplex herpes virus and cytomegalovirus infections; in 7.69% - combination of simplex herpes virus and Epstein-Barre virus and cytomegalovirus infections; in 17.94% - combination of Epstein-Barre virus and cytomegalovirus infections; The particularity of course of persistent herpes infection in children had to do with absence of specific symptoms of nosologic form in 59.2% of cases. The results of analysis of smears from nasopharynx of children infected with herpes viruses permitted to detect: Staphylococcus aureus in 36.36%; Streptococcus haemolyticus-β in 32.32%; Streptococcus haemolyticus-α in 11.11%; Candida albicans of mucous membranes in 4.04% of children. The viral bacterial mixed-infection was detected in 44.44%. The laboratory signs of activity of immune inflammation were detected: increasing of content of TNАα and decreasing of level of IFNγ. The results of study substantiate necessity of individual approach to therapy of children with diseases of upper respiratory ways and ENT-organs and with implementation of complex of curative rehabilitating activities.
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Patoulias D, Koutras C. HSV encephalitis: is the insight of the clinician still crucial for the outcome? Folia Med Cracov 2017; 57:97-105. [PMID: 29337981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Herpes simplex virus (HSV) encephalitis is an acute infection of the Central Nervous System (CNS). During the last two decades its incidence has a ten-fold increase, while mortality rate exceeds 70%, if left undiagnosed and thus untreated. Clinical manifestations, imaging studies, cerebrospinal fluid (CSF) analysis and electroencephalogram (EEG) are the basis of diagnostic approach. Even when CSF analysis seems normal, imaging studies are not specific and HSV polymerase chain reaction (PCR) test is negative, the clinician should be more aggressive, if clinical presentation is indicative for HSV encephalitis, by administrating acyclovir early after patient's admission. The aim of this short review article, after systematic research of the relevant up to date literature, is to emphasize the insight of the clinician as for the early diagnosis and the prompt therapeutic intervention, which are crucial for the outcome and vital for the affected patient.
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Rahnama-Moghadam S, Brown ME, Meffert JJ. Vesicular eruption in a 2-year-old boy. J Fam Pract 2016; 65:E1-E3. [PMID: 27565104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A bath with scented soap prompted a flare of the boy's eczema. Days later, he was hospitalized with diffuse erosions covering 90% of his body. What was the cause?
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Grover D, Newsholme W, Brink N, Manji H, Miller R. Herpes simplex virus infection of the central nervous system in human immunodeficiency virus-type 1-infected patients. Int J STD AIDS 2016; 15:597-600. [PMID: 15339367 DOI: 10.1258/0956462041724163] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report clinical, radiological and virological data from nine consecutive HIV-infected patients with herpes simplex virus (HSV) infection of the central nervous system (CNS). Three patients presented with confusion, two with fever and headache, two with anxiety and depression, one with slow mentation and memory loss and one with expressive dysphasia. Five patients had previous AIDS-defining diagnoses: four of these five patients had previous cutaneous HSV infection. HSV DNA was detected by the polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) in seven patients. HSV infection was diagnosed by brain biopsy (after negative PCR on CSF) in one patient and at autopsy in one patient (after negative CSF PCR and brain biopsy). Seven patients received specific anti-viral therapy; two died of unrelated causes and the other five recovered. Two patients were not treated, in one the diagnosis was made at autopsy and the other recovered spontaneously. HIV-infected patients with CNS HSV infection have a varied presentation. Diagnosis by PCR on CSF identified the majority of cases. With specific treatment the outcome was good.
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Affiliation(s)
- D Grover
- Department of Genitourinary Medicine, Mortimer Market Centre, Camden PCT, London WC1E 6AU, UK
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28
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MONTANO SM, MORI N, NELSON CA, TON TGN, CELIS V, TICONA E, SIHUINCHA M, TILLEY DH, KOCHEL T, ZUNT JR. Herpes simplex virus encephalitis in Peru: a multicentre prospective study. Epidemiol Infect 2016; 144:1673-8. [PMID: 26733400 PMCID: PMC9150612 DOI: 10.1017/s0950268815003222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/02/2015] [Indexed: 01/30/2023] Open
Abstract
Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru.
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Affiliation(s)
| | - N. MORI
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
- Hospital Daniel Alcides Carrion, Callao, Peru
| | - C. A. NELSON
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - T. G. N. TON
- Department of Neurology, School of Medicine, University of Washington, Seattle, WA, USA
| | | | - E. TICONA
- Hospital Dos de Mayo, Lima, Peru
- Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | - T. KOCHEL
- US Naval Medical Research Unit-6, Callao, Peru
| | - J. R. ZUNT
- Department of Neurology, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Global Health, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
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Francis SC, Hou Y, Baisley K, van de Wijgert J, Watson-Jones D, Ao TT, Herrera C, Maganja K, Andreasen A, Kapiga S, Coulton GR, Hayes RJ, Shattock RJ. Immune Activation in the Female Genital Tract: Expression Profiles of Soluble Proteins in Women at High Risk for HIV Infection. PLoS One 2016; 11:e0143109. [PMID: 26814891 PMCID: PMC4729472 DOI: 10.1371/journal.pone.0143109] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/30/2015] [Indexed: 01/20/2023] Open
Abstract
Soluble cervicovaginal biomarkers of inflammation, immune activation and risk of HIV acquisition are needed to reliably assess the safety of new biomedical prevention strategies including vaccines and microbicides. However, a fuller understanding of expression profiles in women at high risk for HIV infection is crucial to the effective use of these potential biomarkers in Phase 3 trial settings. We have measured 45 soluble proteins and peptides in cervicovaginal lavage samples from 100 HIV negative women at high risk for HIV infection. Women were followed over one menstrual cycle to investigate modulation by hormonal contraception, menstrual cycle phase, recent sexual exposure and intravaginal practices. Women using injectable DMPA had increased concentration of several soluble proteins of the innate and adaptive immune system, including IL-1α, IL-1β, IL-2, MIP-1β, IP-10, IL-8, TGF-β, HBD4, IgA, IgG1, and IgG2. Women using combined oral contraceptives had a similar signature. There were differences in concentrations among samples from post-ovulation compared to pre-ovulation, notably increased immunoglobulins. Increased prostate-specific antigen, indicative of recent sexual exposure, was correlated with increased IL-6, MCP-1, and SLPI, and decreased GM-CSF and HBD3. The identified signature profiles may prove critical in evaluating the potential safety and impact on risk of HIV acquisition of different biomedical intervention strategies.
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Affiliation(s)
- Suzanna C. Francis
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- * E-mail:
| | - Yanwen Hou
- Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom
| | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Janneke van de Wijgert
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Trong T. Ao
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Carolina Herrera
- Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom
| | - Kaballa Maganja
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Aura Andreasen
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saidi Kapiga
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania, United Republic of Tanzania
| | - Gary R. Coulton
- Division of Basic Medical Sciences, St. George's Medical School, University of London, London, United Kingdom
| | - Richard J. Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robin J. Shattock
- Mucosal Infection and Immunity Group, Imperial College, Department of Medicine, London, United Kingdom
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Wong AA, Pabbaraju K, Wong S, Tellier R. Development of a multiplex real-time PCR for the simultaneous detection of herpes simplex and varicella zoster viruses in cerebrospinal fluid and lesion swab specimens. J Virol Methods 2015; 229:16-23. [PMID: 26711555 DOI: 10.1016/j.jviromet.2015.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/17/2015] [Accepted: 12/17/2015] [Indexed: 12/19/2022]
Abstract
Herpes simplex viruses (HSV) and varicella zoster virus (VZV) can have very similar and wide-ranging clinical presentations. Rapid identification is necessary for timely antiviral therapy, especially with infections involving the central nervous system, neonates, and immunocompromised individuals. Detection of HSV-1, HSV-2 and VZV was combined into one real-time PCR reaction utilizing hydrolysis probes. The assay was validated on the LightCycler(®) (Roche) and Applied Biosystems 7500 Real-Time PCR System (Thermo Fisher Scientific Inc.) to detect alphaherpesviruses in cerebral spinal fluid (CSF) and lesion swab specimens, respectively. Validation data on blood and tissue samples are also presented. The multiplex assay showed excellent sensitivity, specificity and reproducibility when compared to two singleplex real-time PCR assays for CSF samples and direct fluorescent antigen/culture for lesion swab samples. Implementation of the multiplex assay has facilitated improved sensitivity and accuracy as well as reduced turn-around-times and costs. The results from a large data set of 16,622 prospective samples tested between August 16, 2012 to February 1, 2014 at the Provincial Laboratory for Public Health (Alberta, Canada) are presented here.
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Affiliation(s)
- Anita A Wong
- Provincial Laboratory for Public Health (Microbiology), 3030 Hospital Drive NW, Calgary, Alberta, Canada T2N 4W4
| | - Kanti Pabbaraju
- Provincial Laboratory for Public Health (Microbiology), 3030 Hospital Drive NW, Calgary, Alberta, Canada T2N 4W4.
| | - Sallene Wong
- Provincial Laboratory for Public Health (Microbiology), 3030 Hospital Drive NW, Calgary, Alberta, Canada T2N 4W4
| | - Raymond Tellier
- Provincial Laboratory for Public Health (Microbiology), 3030 Hospital Drive NW, Calgary, Alberta, Canada T2N 4W4; Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
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Chua C, Arnolds M, Niklas V. Molecular diagnostics and newborns at risk for genital herpes simplex virus. Pediatr Ann 2015; 44:e97-102. [PMID: 25996200 DOI: 10.3928/00904481-20150512-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Herpes simplex virus (HSV) infection in the newborn carries a high mortality rate and can result in lifelong neurologic impairment. The severity of HSV infection in the newborn has always dictated conservative management when prodromal symptoms or active genital lesions (or those suggestive of genital herpes) are present during labor and delivery. The risk of intrapartum infection, however, is related to the presence or absence of maternal immunity (neutralizing antibody) to HSV. The most significant risk of transmission is in first-episode primary infections with active lesions at delivery. Recent recommendations from the American Academy of Pediatrics Committees on Infectious Diseases and the Fetus and Newborn use rapid serologic and virologic screening in the management of asymptomatic infants born to mothers with active genital herpes. The revised guidelines highlight infants at greatest risk for HSV disease but do not apply to asymptomatic infants born to mothers with a history of HSV but no genital lesions at delivery. The current guidelines also stipulate that maternal serologic screening and molecular assays for HSV in newborn blood and cerebrospinal fluid must be available and reported in a timely fashion.
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Abstract
In attempts to encompass multiple events responsible for the development of cancer in man, with a particular interest to the possible involvement of viruses, multidisciplinary studies have been conducted on KS during 1971-1979. There is accumulating evidence associating this malignancy with CMV. African KS patients have high antibody titers to CMV, but they are not significantly different from controls of the same regions (Ag-Ab complexes?). A specific serologic association of European and American KS with CMV was established. CMV-related antigens can be demonstrated in 22% of tumor biopsies and comparably in early passages of cell culture derived from them. Recently, CMV-DNA sequences have been detected in tumor biopsies. Furthermore, a CMV, strain K9V, has been isolated in tissue culture from a KS culture. Cells infected in vitro with K9V have shown some of the characteristics of cells transformed previously by other oncogenic CMV strains. In vivo K9V has induced a fatal disease in old world monkeys, mainly involving the lymphoid system. Moreover, a cluster type of occurrence of KS was detected in the West Nile District of Uganda, an area with as high incidence of KS as BL; and finally, there is a significantly higher incidence of a second primary tumor in KS patients, particularly of the lymphoreticular system. Whether CMV plays a role in the development of KS, a complex neoplasia which involves different cell types cannot be claimed by these results only. However, similarities between CMV and EBV, the latter being closely associated with BL and nasopharyngeal carcinoma are worthy of consideration.
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Polz-Gruszka D, Stec A, Dworzański J, Polz-Dacewicz M. EBV, HSV, CMV and HPV in laryngeal and oropharyngeal carcinoma in Polish patients. Anticancer Res 2015; 35:1657-1661. [PMID: 25750324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The role of viruses in the etiology of oral cancer has been proposed in many studies. The aim of the present study was to analyze the prevalence of Epstein-Barr virus, Human Herpes virus type 1, Cytomegalovirus and Human Papilloma virus among patients with oral squamous cell carcinoma in a Polish population. We investigated fresh-frozen tumor tissue fragments obtained from 80 patients with OSCC using the polymerase chain reaction assay. HPV was detected in 32.5% (22.5% were HPV 16), more often in laryngeal (36%) than in oropharyngeal carcinoma (26.6%). EBV was identified in 57.5%, HHV-1 in 7.5%, and CMV in 10% of patients. Co-infection with one or more viruses was detected in 30% of cases and most frequently it was co-infection with EBV and HPV (15%). Further studies are necessary to determine the potential role of EBV and the possible importance of HHV-1 as an infection co-factor in oropharyngeal cancer.
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Affiliation(s)
| | - Agnieszka Stec
- Department of Virology, Medical University of Lublin, Lublin, Poland
| | - Jakub Dworzański
- Department of Virology, Medical University of Lublin, Lublin, Poland
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Butorin NN, Tsukanov VV, Vasjutin AV, Reznikova OS, Vershinina GR, Kim MA. [ESOPHAGITIS, CAUSED BY HERPES SIMPLEX VIRUS: CASE REPORT]. Eksp Klin Gastroenterol 2015:94-97. [PMID: 26415273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The clinical observation of the patient at the age of 56 years, with lesions of the esophagus by the herpes simplex virus has been presented. The patient complained of odynophagia and dysphagia. Treatment with proton pump inhibitors in outpatient stage was not effective. On endoscopic examination revealed multiple ulcers in all parts of the esophagus. Herpes simplex virus has been detected in biopsy specimens of esophageal mucosa by the PCR method. Treatment with acyclovir led to rapid and complete clinical recovery. Analysis of the literature allowed making the conclusion about the importance and actuality this demonstration.
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Sakai T, Abe Y, Sassa K, Yamanouchi H. [A case of neonatal herpes simplex virus encephalitis with characteristic MRI features in the early period]. No To Hattatsu 2014; 46:447-449. [PMID: 25558589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Gimenes F, Medina FS, de Abreu ALP, Irie MMT, Esquiçati IB, Malagutti N, Vasconcellos VRB, Discacciati MG, Bonini MG, Maria-Engler SS, Consolaro MEL. Sensitive simultaneous detection of seven sexually transmitted agents in semen by multiplex-PCR and of HPV by single PCR. PLoS One 2014; 9:e98862. [PMID: 24921247 PMCID: PMC4055596 DOI: 10.1371/journal.pone.0098862] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/07/2014] [Indexed: 01/12/2023] Open
Abstract
Sexually transmitted diseases (STDs) may impair sperm parameters and functions thereby promoting male infertility. To date limited molecular studies were conducted to evaluate the frequency and type of such infections in semen Thus, we aimed at conceiving and validating a multiplex PCR (M-PCR) assay for the simultaneous detection of the following STD pathogens in semen: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Herpes virus simplex (HSV) −1 and −2, and Treponema pallidum; We also investigated the potential usefulness of this M-PCR assay in screening programs for semen pathogens. In addition, we aimed: to detect human Papillomavirus (HPV) and genotypes by single PCR (sPCR) in the same semen samples; to determine the prevalence of the seven STDs, HPV and co-infections; to assess the possibility that these infections affect semen parameters and thus fertility. The overall validation parameters of M-PCR were extremely high including agreement (99.2%), sensitivity (100.00%), specificity (99.70%), positive (96.40%) and negative predictive values (100.00%) and accuracy (99.80%). The prevalence of STDs was very high (55.3%). Furthermore, associations were observed between STDs and changes in semen parameters, highlighting the importance of STD detection in semen. Thus, this M-PCR assay has great potential for application in semen screening programs for pathogens in infertility and STD clinics and in sperm banks.
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Affiliation(s)
- Fabrícia Gimenes
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | - Fabiana Soares Medina
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | - André Luelsdorf Pimenta de Abreu
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | - Mary Mayumi Taguti Irie
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | - Isis Baroni Esquiçati
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | - Natália Malagutti
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Michele Garcia Discacciati
- Clinical Chemistry and Toxicology Department, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Marcelo Gialluisi Bonini
- College of Medicine, Department of Pharmacology, University of Illinois at Chicago, Illinois, Chicago, United States of America
| | - Silvya Stuchi Maria-Engler
- Clinical Chemistry and Toxicology Department, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Marcia Edilaine Lopes Consolaro
- Section of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
- * E-mail:
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Presas-Rodríguez S, Hernández-Pérez M, Grau-López L, Massuet-Vilamajó A, Ramo-Tello C. [Lesion of the trigeminal nucleus caused by herpes simplex virus]. Rev Neurol 2013; 57:526-527. [PMID: 24265148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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39
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Lewin JM, Farley-Loftus R, Pomeranz MK. Herpes simplex virus-associated pseudolymphoma. Cutis 2013; 92:E1-E2. [PMID: 24416749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Jesse M Lewin
- New York University Langone Medical Center, The Ronald O. Perelman Department of Dermatology, 240 E 38th Ave, New York, NY 10016, USA.
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Kahraman ŞŞ, Çokkeser Y, Gülmez Mİ, İnan MU. [Head and neck space infection presenting with Herpes Simplex virus]. Kulak Burun Bogaz Ihtis Derg 2013; 23:341-343. [PMID: 24283809 DOI: 10.5606/kbbihtisas.2013.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A six-year-old girl was admitted to our clinic with the complaints of swelling, trismus, pain in the submandibular, submental and masticator area and vesicular lesions on the mandibular branch of trigeminal nerve (C5, V3). We present this case of head and neck space infection presenting with Herpes Simplex virus, as it is rarely seen.
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Affiliation(s)
- Şerif Şamil Kahraman
- Department of Otolaryngology, Medical Faculty of Mustafa Kemal University, 31000 Hatay, Turkey.
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Zhang XS, Wang XX, Yu DS, Jiang JX, Zhang GY, Wang F, Li H. [Analysis of pathogen spectrum of Encephalitis/Meningitis in northwestern area of China]. Zhonghua Yu Fang Yi Xue Za Zhi 2013; 47:924-927. [PMID: 24378133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To learn the characteristics of pathogen spectrum of Encephalitis /Meningitis in northwestern area of China. METHODS Between January 1st 2009 and March 31st 2011, a total of 569 patients with clinical symptoms of Encephalitis/Meningitis were selected from the hospitals in Gansu, Qinghai,Inner Mongolia and Xinjiang province. 1514 samples of specimen were collected from the 515 patients, to detect the IgM of Japanese encephalitis virus (JEV), enterovirus (EV, including Coxsackie virus, ECHO virus and enterovirus 71), Mumps virus, Herpes simplex virus (HSV) in blood and cerebrospinal fluid. Meanwhile, Neisseria meningitis (Nm), Haemophilus influenzae Type B (Hib), Staphylococcus, Streptococcus pneumonia, Streptococcus Suis, E. Coli and Cryptococci were also identified. The detection results were analyzed by different region, time and age range. RESULTS Pathogenic bacteria were identified in the specimen from 16 patients, with the rate at 3.65%, of which the dominant ones were Streptococcus pneumonia (7 patients, 43.75%). Virus were identified in the specimen from 132 patients, with the rate at 27.05%, of which the dominant types were EV and HSV, accounting for 33.33% (44 cases) and 31.82% (42 cases) respectively. The detection rate of virus showed a significant seasonal trend, with the peak appearing between June and November each year. The peak of EV detection was between July and September, with 24 cases detected out; the peak of HSV was between June and August (11 cases detected out); mumps virus was mainly found between July and December (25 cases). There was no significant time-distribution found in the detection of bacteria. The EV and HSV were mainly distributed in Gansu and Qinghai province (70 cases) ;most of mumps virus were found in Gansu province (24 cases);and JEV were only found in Gansu province (20 cases). The viral pathogen spectrum was identified in all ages, and the EV and mumps virus were mainly found in children aged 0-14 years old (42 and 17 cases respectively) ; JEV were identified in people over 15 years old, with 13 detected out of the 20 patients. CONCLUSION The main pathogen of acute encephalitis and meningitis in northwestern area of China was virus, and the main pathogens of encephalitis and meningitis in children under 15 years were Herpes simplex virus and Mumps virus.
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Affiliation(s)
- Xiao-shu Zhang
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Xu-xia Wang
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China
| | - De-shan Yu
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Jian-xiang Jiang
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Guang-ye Zhang
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Fang Wang
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Hui Li
- Office for Immunization Programme of Gansu Center for Disease Control and Prevention, Lanzhou 730000, China.
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Csonka T, Szepesi R, Bidiga L, Péter M, Klekner A, Hutóczky G, Csiba L, Méhes G, Hortobágyi T. [The diagnosis of herpes encephalitis--a case-based update]. Ideggyogy Sz 2013; 66:337-342. [PMID: 24358690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Herpes simplex virus encephalitis (HSVE) is a rare and life-threatening infection. The clinical signs are diverse and often misleading regarding the aetiology. However, focal seizure with fever and typical CT/MRI finding should always raise the possibility of HSVE as early diagnosis and antiviral therapy is crucial. Before the advent of molecular techniques and high-tech imaging histological examination from multiple brain biopsies were often necessary. Although nowadays PCR and other molecular methods may provide an aetiological diagnosis some cases need neuropathological verification. Due to the high IgG seropositivity rate in the population the plasma IgG titer is not diagnostic and elevation of its plasma level requires several weeks. We report the case of a 25-years old male patient who initially presented with epileptic seizures. There was no final diagnosis and no causal treatment in the district general hospital. The patient was admitted to our institution in comatose state on day 9; the initiated diagnostic tests and therapy could not save the patient who died next day. The autopsy and subsequent neuropathological examination revealed HSVE. We present a flowchart on diagnostic work-up and special techniques to aid diagnosis in suspected viral encephalitis.
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Affiliation(s)
- Tamás Csonka
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Patológiai Intézet, Neuropatológiai Tanszék, Debrecen
| | - Rita Szepesi
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Neurológiai Klinika, Debrecen
| | - László Bidiga
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Patológiai Intézet, Debrecen
| | - Mózes Péter
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Radiológiai Klinika, Debrecen
| | - Almos Klekner
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Idegsebészeti Klinika, Debrecen
| | - Gábor Hutóczky
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Idegsebészeti Klinika, Debrecen
| | - László Csiba
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Neurológiai Klinika, Debrecen
| | - Gábor Méhes
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Patológiai Intézet, Debrecen
| | - Tibor Hortobágyi
- Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Patológiai Intézet, Neuropatológiai Tanszék, Debrecen
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Greenwell TH, Loh RS, Chehade M, Mills RAD. Misdiagnosis of orthokeratology-related Acanthamoeba keratitis as herpes simplex virus keratitis. Clin Exp Ophthalmol 2013; 41:418-20. [PMID: 23231627 DOI: 10.1111/ceo.12047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 09/03/2012] [Indexed: 11/26/2022]
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Di Crescenzo V, D'Antonio A, Tonacchera M, Carlomagno C, Vitale M. Human herpes virus associated with Hashimoto's thyroiditis. Infez Med 2013; 21:224-228. [PMID: 24008857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Hashimoto's thyroiditis is the most frequent autoimmune disease with genetic and environmental aetiologies. Viral infections have been postulated as one of the factors that may trigger autoimmune diseases. Many studies suggest that Herpes simplex virus infections are involved in a variety of autoimmune diseases. We report the case of three patients presenting for the first time herpes labialis a few months before the onset of hashitoxicosis. Serological and clinical exams support the possible role of human herpes viruses in the aetiology of Hashimoto's thyroiditis.
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Affiliation(s)
- Vincenzo Di Crescenzo
- Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno; Department of Endocrinology, Research Center of Excellence AmbiSEN, University of Pisa, Pisa; Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
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Flaxel CJ, Yeh S, Lauer AK. Combination systemic and intravitreal antiviral therapy in the management of acute retinal necrosis syndrome (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2013; 111:133-144. [PMID: 24385671 PMCID: PMC3868412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To compare the outcomes of combination systemic and intravitreal antiviral therapy vs systemic antiviral therapy alone for treating acute retinal necrosis syndrome (ARN). We hypothesize that combination therapy might result in superior visual acuity (VA) and retinal detachment (RD) outcomes vs traditional systemic antiviral therapy alone. METHODS A retrospective, interventional, comparative single-center study of patients with ARN. We reviewed demographic data, herpesvirus diagnoses, polymerase chain reaction (PCR) results, VA, RD, and the use of systemic and intravitreal antiviral therapy. Outcome measures included VA improvement by 2 or more lines, severe visual loss, VA ≤20/200, and RD. RESULTS We studied 29 eyes of 24 patients, treated from 1987 through 2009. Mean age was 42.6 years and mean follow-up was 44.0 months. Twelve patients (14 eyes) were treated with combined systemic and intravitreal antiviral therapy and 12 patients (15 eyes) with systemic therapy alone. Kaplan-Meier survival analysis revealed that patients receiving combination intravitreal and systemic antiviral therapy were more likely to have VA improved by 2 lines or greater (P=.006). Patients receiving combination therapy also showed a decreased incidence of progression to severe visual loss (0.13/patient-years [PY]) compared to patients receiving systemic therapy alone (0.54/PY, P=.02) and had decreased incidence of RD (0.29/PY vs 0.74/PY, P=.03). CONCLUSIONS Combination oral and intravitreal antiviral therapy may improve visual and functional outcomes in patients with ARN. Clinicians should consider prompt administration of combination systemic and intravitreal antiviral therapy as first-line treatment for patients with clinical features of ARN.
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MESH Headings
- 2-Aminopurine/analogs & derivatives
- 2-Aminopurine/therapeutic use
- Acyclovir/analogs & derivatives
- Acyclovir/therapeutic use
- Administration, Oral
- Adult
- Antiviral Agents/therapeutic use
- Aqueous Humor/virology
- Cytomegalovirus/isolation & purification
- DNA, Viral/analysis
- Drug Therapy, Combination
- Eye Infections, Viral/diagnosis
- Eye Infections, Viral/drug therapy
- Eye Infections, Viral/virology
- Famciclovir
- Female
- Humans
- Injections, Intravenous
- Intravitreal Injections
- Male
- Middle Aged
- Polymerase Chain Reaction
- Retinal Detachment
- Retinal Necrosis Syndrome, Acute/diagnosis
- Retinal Necrosis Syndrome, Acute/drug therapy
- Retinal Necrosis Syndrome, Acute/virology
- Retrospective Studies
- Simplexvirus/isolation & purification
- Treatment Outcome
- Valacyclovir
- Valine/analogs & derivatives
- Valine/therapeutic use
- Visual Acuity/physiology
- Vitreous Body/virology
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Affiliation(s)
- Christina J Flaxel
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon (Dr Flaxel, Dr Lauer), and Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia (Dr Yeh)
| | - Steven Yeh
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon (Dr Flaxel, Dr Lauer), and Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia (Dr Yeh)
| | - Andreas K Lauer
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon (Dr Flaxel, Dr Lauer), and Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia (Dr Yeh)
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Jetté-Côté I, Ouellette D, Béliveau C, Mitchell A. Total dysphagia after short course of systemic corticotherapy: Herpes simplex virus esophagitis. World J Gastroenterol 2013; 19:5178-5181. [PMID: 23964155 PMCID: PMC3746393 DOI: 10.3748/wjg.v19.i31.5178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/27/2013] [Accepted: 06/10/2013] [Indexed: 02/06/2023] Open
Abstract
A 72 year-old female developed a herpetic esophagitis after 3 d of oral corticotherapy for an acute exacerbation of chronic obstructive pulmonary disease, presenting as odynophagia and total dysphagia. Biospies were taken during a first esophagogastroduodenoscopy (EGD) and the patient was referred to the thoracic surgery service with a presumptive diagnosis of esophageal cancer. A second EGD was planned for dilatation, but by that time the stenosis was completely resolved. The biopsies taken during the first EGD revealed multiple herpetic viral inclusions and ulcerations without any dysplasia or neoplasia. In front of a severe esophageal stenosis, one must still exclude the usual differential diagnosis peptic stenosis and cancer. Visualization of endoscopic lesions can suggest the diagnosis but must be promptly confirmed by biopsy, viral culture or polymerase chain reaction. Although immune systemic effects of corticotherapy are well known and herpetic esophagitis occurs most frequently in immunocompromised individuals, this case emphasizes the importance of clinical awareness concerning short courses of corticotherapy for immunocompetent individuals. This article discusses the reactivation process of herpetic infection in this context and addresses its diagnostic and therapeutic issues.
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48
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Ladizinski B, Carter JB, Lee KC, Aaron DM. Diagnosis of herpes simplex virus-induced erythema multiforme confounded by previous infection with Mycoplasma pneumonia. J Drugs Dermatol 2013; 12:707-709. [PMID: 23839193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Erythema multiforme (EM) is an immune-mediated hypersensitivity reaction often related to viral infection or medications. Infection-induced EM is typically self-limited and commonly caused by herpes simplex virus (HSV) or Mycoplasma pneumoniae (MP); recurrent EM is almost always associated with HSV. We present a concise overview of diagnostic techniques for HSV and MP, as repeatedly elevated MP titers in our case led to a delayed diagnosis of HSV-induced EM.
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Affiliation(s)
- Barry Ladizinski
- Department of Dermatology, Duke University Hospital, Durham, NC, USA.
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Drahos J, Vanwormer JJ, Greenlee RT, Landgren O, Koshiol J. Accuracy of ICD-9-CM codes in identifying infections of pneumonia and herpes simplex virus in administrative data. Ann Epidemiol 2013; 23:291-3. [PMID: 23522903 PMCID: PMC3654522 DOI: 10.1016/j.annepidem.2013.02.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 02/01/2013] [Accepted: 02/09/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Clinical epidemiology studies increasingly rely on electronic medical records data. The validity of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes is crucial as they are often used to identify conditions of interest. We evaluated the use of archived ICD-9-CM codes to identify two representative infection-related conditions, pneumonia and herpes simplex virus (HSV), in a defined health system. METHODS Records were obtained for a sample of 175 and 179 patients with ICD-9-CM codes for pneumonia and HSV, respectively. An adjudicated case status was assigned for each subject. RESULTS The presence of a single ICD-9-CM code had a positive predictive value of 88% for pneumonia and 86% for HSV. False positives (noncases) accounted for less than 10% of records evaluated for each condition. CONCLUSIONS Our study demonstrates that ICD-9-CM codes for pneumonia and HSV were valid markers of a true history of these conditions, suggesting that ICD-9-CM codes can be used to successfully identify infection-related conditions in epidemiologic studies. However, validation studies for individual conditions may help identify condition-specific strategies to improve the performance of diagnostic codes.
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Affiliation(s)
- Jennifer Drahos
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20852-7234, USA.
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Abstract
Neonatal herpes simplex virus infections are uncommon, but because of the morbidity and mortality associated with the infection they are often considered in the differential diagnosis of ill neonates. The use of polymerase chain reaction for diagnosis of central nervous system infections and the development of safe and effective antiviral therapy has revolutionized the diagnosis and management of these infants. Initiation of long-term antiviral suppressive therapy in these infants has led to significant improvement in morbidity. This article summarizes the epidemiology of neonatal herpes simplex virus infections and discusses clinical presentation, diagnosis, management, and follow up of infants with neonatal herpes disease.
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Affiliation(s)
- Swetha G Pinninti
- Division of Pediatric Infectious Diseases, The University of Alabama at Birmingham, Birmingham, AL 35233, USA
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