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At least 685 records · Page 38Linked to original sources
PubMed2001

Imaging findings in rabies encephalitis.

SUMMARY: Rabies encephalitis is perhaps one of the few infectious diseases that command attention and fear not only from the layman but also from physicians. The unique mode of transmission, the virtually exclusive neurotransmission shown by the agent, and the complete hopelessness of the established disease sets rabies apart from other zoonoses transmitted to man. Rabies encephalitis is a fatal disease and its diagnosis is usually based on the clinical presentations and findings. Hence, imaging in rabies is seldom done, and imaging findings in rabies encephalitis have rarely been described. We present the imaging findings in two confirmed cases of rabies encephalitis in which antemortem diagnosis was obtained by corneal impression smears showing the presence of viral antigens. The differential diagnosis of the imaging findings as well as the role and the relevance of imaging in the diagnosis of this disease are discussed. The current literature on the subject is also reviewed.

Adult↗
PubMed2001

[Tick-borne encephalitis in Norway].

BACKGROUND: Tick-borne encephalitis is caused by a virus that is transmitted to man by tick-bite. The virus is found in central and eastern parts of Europe and also in Sweden. MATERIAL AND METHODS: We report the first two cases of tick-borne encephalitis resulting from transmission of virus in Norway. RESULTS: Both patients had been to the island of Tromøy on the south coast of Norway. The course of the disease was very different in the two patients. One patient had significant neurological dysfunction. The other patient had intense headache, but no motor dysfunction. Both patients had reduced general health and fever, and leukocytosis and increased protein was found in the spinal fluid. The incubation period is most often 1 to 2 weeks. The disease may have a bi-phasic course with initial fever, headache and muscle pain. One week later symptoms of encephalitis follow. Subclinical infection is common, especially in children. One third of patients get permanent sequelae after encephalitis. Diagnosis is made by demonstration of antibodies in serum. Treatment is symptomatic. INTERPRETATION: These two patients indicate that there may be a reservoir of TBE virus in Norway.

Aged↗
PubMed2002

Subcortical low intensity on MR images of meningitis, viral encephalitis, and leptomeningeal metastasis.

BACKGROUND AND PURPOSE: Subcortical low-intensity lesion on T2-weighted images is an uncommon manifestation of ischemia, multiple sclerosis, and Sturge-Weber disease. This study was performed to determine whether subcortical low signal intensity is an MR feature of meningitis, viral encephalitis, or leptomeningeal metastasis and to investigate a cause of subcortical low intensity. METHODS: We retrospectively reviewed MR images of 117 patients with meningitis, encephalitis (viral or unknown), or leptomeningeal metastasis for the presence of subcortical low intensity, meningeal enhancement, signal intensity change of cortex, and change in subcortical low intensity on follow-up images. Diffusion-weighted (DW) images and apparent diffusion coefficient (ADC) maps were obtained in 55 patients. Subcortical low-intensity lesions were also quantitatively analyzed on T2-weighted, fluid-attenuated inversion recovery (FLAIR), and DW images. RESULTS: Subcortical low intensity was found in nine (23.7%) of 38 patients with encephalitis (viral, 31; unknown origin, 7), five (24%) of 21 with leptomeningeal metastasis, and five (9%) of 58 with meningitis. Leptomeningeal enhancement was observed in 100% and cortical hyperintensity in 14 (74%) of 19 patients with subcortical low intensity. Leptomeningeal enhancement was seen in 46 (47%) and cortical hyperintensity in 33 (34%) of 98 patients without subcortical low intensity. Subcortical low intensity disappeared or decreased in extent on follow-up MR images in all seven patients who underwent follow-up. ADC of subcortical low-intensity lesions was lower than that of the contralateral area and decreased by 9.3 +/- 11.4%. CONCLUSION: Subcortical low intensity was uncommonly found in meningitis, viral encephalitis, and leptomeningeal metastasis. It is a nonspecific MR sign of various meningeal and cortical diseases. Although the cause of subcortical low intensity remains uncertain, free radical formation may play a role as a causative factor.

Adolescent↗
PubMedDate not supplied

[The role of nitric oxide in Listeria encephalitis of ruminants and in rats intracisternally infected with Listeria monocytogenes].

Listeria monocytogenes is a Gram-positive facultative intracellular bacteria which infects a wide range of hosts. In ruminants, infection with L. monocytogenes frequently causes encephalitis, which is usually fatal in sheep and goat, while cattle often recover with antibiotic therapy. Since the role of NO in the control of Listeria is controversial, we have studied the expression of iNOS in the brains of cattle, sheep and goats which had succumbed to listeria encephalitis. iNOS was demonstrated in decreasing intensity in the M phi of microabscesses from cattle, sheep and goat. iNOS expression was accompanied by NT in the microabscesses of cattle, but was only present to a low degree in sheep and was absent in goats. This is indirect evidence for differences in the ability to produce NO in the three species. Presence of iNOS and NT were inversely correlated with the numbers of bacteria. While microabscesses of goats contained high amounts of L. monocytogenes they occurred only rarely in cattle. To corroborate our hypothesis that NO is involved in the control of listeria encephalitis a new animal model was developed. Eleven day old infant rats were infected intracisternally with a low dose of L. monocytogenes. This resulted in a transient meningoencephalitis with moderate clinical signs and low mortality. Listeria proliferated strongly in the inflammatory lesions during the first days of infection, reached a peak at day 4 and were eliminated until day 7. The presence of bacteria was closely accompanied by high numbers of iNOS-expressing M phi and the formation of NT. Administration of the iNOS inhibitor L-NIL or the radical scavenger PBN resulted in rapid death of the treated animals. However, the increase in bacterial numbers was one order of magnitude higher for animals treated with PBN compared with L-NIL administration. This shows that NO plays an important role in the control of a brain infection with Listeria, but suggests that reactive oxidants other than NO are also involved. In conclusion, our findings point to a possible involvement of the differences in the ability to express iNOS and subsequent NO production in the different clinical outcome of listeria encephalitis in cattle and small ruminants.

Animals↗
PubMedDate not supplied

[Encephalitis caused by Rickettsia conorii without exanthema].

INTRODUCTION: Mediterranean boutonneuse fever, caused by Rickettsia conorii, is an endemic disease in the Mediterranean area. The serious forms of the disease, which include encephalitis, are infrequent but are associated with a high mortality rate. Diagnostic suspicion is backed up by the development of exanthema. We report the case of a patient who developed encephalitis caused by Rickettsia conorii without exanthema. Clinical case. A 27 year old woman who had nauseas, headache, fever, abdominal upset and generalised pain during the days before being admitted to hospital. On the day she was admitted, she noticed reduced strength in the left limbs, together with numbness and pins and needles in the left side of the body. In the casualty department she presented tonic seizures in the left extremities and later generalised tonic clonic seizures. Exploration showed facial paresis and 4/5 hemiparesis on the left side. Complementary tests carried out in casualty, including cerebrospinal fluid (CSF), did not reveal any significant findings. She was admitted after a loading dose of phenytoin. After 48 hours she presented fever and repeated complex partial seizures. A new CSF analysis was normal. She was treated with valproate, clonazepam, ceftriaxone, doxycycline and acyclovir. An electroencephalogram (EEG) showed theta activity in the left centroparietal areas and slow delta waves in the right temporal regions. Magnetic resonance imaging (MRI) of the brain showed contrast enhancement in the meninges. 24 later, due to the frequency of the seizures, phenobarbital and methylprednisolone were added, which enabled the seizures to be controlled. The posterior brain MRI revealed a right parasylvian lesion. Serological Rickettsia conorii IgM +, IgG 1/256 was administered. After eight months, she has presented no seizures or neurological deficit. CONCLUSIONS: There are cases of encephalitis from Rickettsia conorii that can present without exanthema. This means that in endemic areas early treatment with doxycycline could be advisable when faced with encephalitis of unknown aetiology, bearing in mind the high mortality rate that occurs when no early treatment is administered and the good tolerance to doxycycline.

Acyclovir↗
PubMed2003

Pathologic mechanisms of influenza encephalitis with an abnormal expression of inflammatory cytokines and accumulation of mini-plasmin.

The pathogenesis of influenza encephalopathy or encephalitis is poorly understood. This review summarizes our recent studies of the roles played by inflammatory cytokines, inducible nitric oxide synthase (iNOS), adhesion molecules and mini-plasmin in influenza encephalitis. After the intranasal infection of newborn mice with the non-neurotropic strain of influenza A virus (IAV) Aichi/2/68/H3N2, encephalitis and severe brain edema were observed within 3-5 days. IAV-RNA and abnormalities in the blood-brain barrier permeability were detected in association with an increase in the mRNA expressions of endothelin-1, iNOS, and tumor necrosis factor-alpha. Furthermore, the accumulation in the brain capillaries of mini-plasmin, which proteolytically induces the viral envelope fusion activity and allows the virus to enter the cells, changes the brain from non-susceptible to susceptible to non-neurotropic IAV multiplication. The accumulation of mini-plasmin was markedly greater in newborn mice with an impaired mitochondrial fatty acid metabolism. These inflammatory mediators and the accumulation of mini-plasmin in the brain may play an important role in the onset and progression of LAV encephalitis.

Animals↗
PubMed2003

Postinfectious encephalitis (21 cases appended).

OBJECTIVE: To report 21 cases of postinfectious encephatitis according to ICD-NA, postinfectious/parainfectious encephalitis is an independent disease. METHODS: Using the uniform criteria provided by The Council of State and Territorial Epidemiologists (CSTE) and Centers for Disease Control and Prevention (CDC), we diagnosed postinfectious encephalitis among patients admitted to The First Hospital of Harbin Medical University and analyzed the characteristics of these cases. RESULTS: All the patients had histories of preceding infection, and most of them suffered from mental and conscious disorders. Adrenocortical hormone was effective. CONCLUSIONS: Postinfectious encephalitis is an independent disease. According to this article, about 10% patients with encephalitis admitted to our hospital are postinfectious.

Adolescent↗
PubMed1992

Postinfectious myelitis, encephalitis and encephalomyelitis.

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

Adrenal Cortex Hormones↗
PubMedDate not supplied

Correlates of SIV encephalitis in rhesus monkeys.

Necropsy records from 204 SIV-infected rhesus monkeys that had been inoculated with various strains of SIV and had died of SIV-related disease were reviewed. The relationship of SIV encephalitis with other parameters was evaluated. Encephalitis was associated with the presence of syncytial cells in other tissues, with persistent or early recurrent antigenemia, with a selective decrease in CD4+CD29+ blood lymphocytes, and with a shortened time of survival. Monkeys whose lymphocytes produced high levels of virus in culture also had a higher incidence of encephalitis. SIV was more frequently isolated from the brains of animals with encephalitis. No other clear associations were detected.

Animals↗
PubMed2003

[An adult case suspected of recurrent measles encephalitis with psychiatric symptoms].

An adult case of suspected recurrent measles encephalitis with psychiatric symptoms is reported. A 46-year-old woman developed measles encephalitis presenting as schizophreniform disorder and recovered three months after onset. However, approximately two years later, she suffered a relapse of encephalitis presenting with psychiatric symptoms (auditory hallucination, cenesthopathy, insomnia, depressive mood) and became comatose. Following ten days of symptomatic treatment, her clinical symptoms gradually improved. Three months later, she made a remarkable recovery without neurological sequelae. Since then, she has maintained good condition for six years. The diagnosis of suspected recurrent measles encephalitis was made on the basis of the change of anti-measles IgM antibody titers. Acute relapse of disseminated encephalomyelitis (ARDEM) and multiple sclerosis (MS) were ruled out due to no abnormal finding of cerebral white matter on MRI. Six years after the recurrent episode, the titers of anti-measles IgM antibodies (EIA) in the serum were still high, suggesting that she was suffering from a chronic measles virus infection. This patient should be followed up for a longer time because there is a possibility that she might be in the latent period of subacute sclerosing panencephalitis (SSPE).

Encephalitis, Viral↗
PubMed2003

Paranoid syndrome and herpes simplex encephalitis--coincidence or casual nexus?

Patients with viral infection of the central nervous system are often difficult to establish the correct diagnosis. This paper presents our knowledge of herpes simplex encephalitis and a case report of 25-year-old woman. In this case paranoid syndrome preceded viral encephalitis. We established that the presence of mental abnormalities could go before encephalitis or could dominate in symptomatology of encephalitis.

Adult↗
PubMed2004

[The application of remote sensing data in epidemic situation analysis of malaria and encephalitis B].

OBJECTIVE: To explore the epidemic regularity of malaria and encephalitis B by using the data of remote sensing (Rs) in flood area. METHODS: The demarcation standards in counties with flood disaster were formed depending on the descriptive analysis results of remote sensing data and combined with that of field survey. Three indicators were used to analyze the epidemic situation of malaria and encephalitis B in Jiangxi Province during a heavy flooding in 1998: the increasing percentage of incidence in 1998 comparing with the median of past five years (1993-1997), the increasing percentage of incidence in 1998 comparing with that of 1997, the increasing percentage of incidence in 1999 comparing with that of 1998. RESULTS: The demarcation standards of flooding counties were defined as follows: by Rs, a county with a flood area of over 100 thousand mu was classified into group one, a county with a flood area under 100 thousand mu was classified into group two, a county with reported flood but not identified by RS was classified into group three, the other counties in the province were classified into group four. The malaria incidence in the province in 1998 was at an average historical level. Compared with 1997, malaria incidence in each group increased in 1998 by 111.61% in group one, 97.50% in group two, 43.63% in group three. So there is an evident correlation between the flood area by Rs and the increasing of malaria incidence (Rs = 0.893, P < 0.05). Malaria incidence in 1999 in non-flood area increased by 83.39% in comparison with that of 1998. The encephalitis B incidence increased by 252.03% in 1998 in group four compared with that of 1997; while the incidence increased in all the four groups in 1999 than that of in 1998. CONCLUSION: The remote sensing data on flood can help fully analyze the epidemic situation of malaria and encephalitis B.

China↗
PubMed2004

[Herpes encephalitis at children].

Significant mortality, high incidences of complications and permanent neurological sequel are still noted in patients suffering fro herpetic encephalitis. They result mainly from delayed diagnosis and treatment of the specific cause. The aim of our paper was the analysis o a clinical course of patients with Herpes simplex encephalitis. From 1999 to 2001 7 patients aged 2 weeks to 15 years, treated in Children' Neurology Department of Silesian School of Medicine, were diagnosed to have herpetic encephalitis. Fever, headache, vomiting, as well as alteration of consciousness, all typical for neuroinfection were main clinical symptoms present on admission. Three children presented with respiratory distress requiring admission to Intensive Care Unit. On examination "cold sores" were found in 2 patients, in remaining 5 the history of exposition to herpes labialis was obtained. On neurological examination we found either right or left hemiparesis in all patients, motor aphasia in 2 and left sided central facial nerve palsy in 1. Lumbar puncture revealed lymphocytosis in 5 patients. Anti-HSV type IgG an IgM antibodies were found in serum of all 6 patients, while only in 2 of them were detected in cerebrospinal fluid (CSF). These were the 2 most severely ill children. In 2 patients DNA HSV using PCR (polymerase chain reaction) method was found in CSF and in serum. Magnetic resonance imaging (MRI) of the head confirmed diagnosis. Although herpetic encephalitis is an uncommon, sporadic disease, the diagnosis should be considered in any child with neuroinfection and early treatment started before laboratory confirmation.

Adolescent↗
PubMed2005

Pilomotor seizures and status in non-paraneoplastic limbic encephalitis.

BACKGROUND AND AIMS: To describe an unusual clinical presentation of a patient with voltage-gated potassium channel Ab- positive, non-paraneoplastic limbic encephalitis. METHODS: We performed video-EEG monitoring, structural MRI, (18)F-FDG-PET, (1)H-MRS, neuropsychological testing and antibody serology. RESULTS: A 42-year-old male patient presented in an acute phase of non-paraneoplastic limbic encephalitis confirmed by MRI, with antibodies to voltage-gated potassium channels. His pilomotor status was pharmacoresistant to antiepileptic drugs, but responded to corticosteroid and azathioprine treatment. The MRI findings improved. The pilomotor seizures recurred when the immunosuppressive therapy was discontinued after 18 months. MRI at that time was consistent with hippocampal sclerosis. Complete seizure control was achieved after reintroduction of steroids. CONCLUSION: Pilomotor seizures were the predominant seizure type in this case of non-paraneoplastic limbic encephalitis. Immunosuppressive therapy may provide recovery including seizure control. However, long-term immunosuppression may be necessary to prevent relapse. Hippocampal sclerosis and chronic epilepsy might evolve as sequelae of limbic encephalitis.

Adult↗
PubMed2005

Therapy of focal viral encephalitis in children with aciclovir and recombinant beta-interferon - results of a placebo-controlled multicenter study.

Focal viral encephalitis in childhood is a rare but life-threatening disease. Animal experiments and case reports suggest a positive effect of an additional therapy with interferon-beta on the course of the disease. Therefore, we initiated a prospective, double-blind placebo-controlled study to investigate the benefit of a combination therapy of Aciclovir (ACV) and recombinant interferon-beta (rIFN-beta) in juvenile focal viral encephalitis. - Initial inclusion criterium was suspicion of focal viral encephalitis. Diagnosis was proven by demonstration of characteristic focal lesions in cerebral imaging or virological evidence of HSV in cerebrospinal fluid. Patients were treated with ACV plus rIFN-beta or ACV plus placebo. Neurological outcome was determined 21 days and 3 months after onset of the disease. - Initially 59 patients were enrolled in the study. Encephalitis was proven in 14 patients (7 ACV + rIFN-beta, 7 ACV + placebo). The study groups were balanced in terms of important prognostic criteria. 10 patients (5 ACV + rIFN-beta, 5 ACV + placebo) were cured or had slight defects, 4 patients (2 ACV + rIFN-beta, 2 ACV + placebo) showed moderate to severe defects. There was no significant difference in favour of the additive therapy with rIFN-beta.

Acyclovir↗
PubMed2005

[Clinical and epidemiological aspects of Japanese encephalitis].

Japanese encephalitis has been well controlled in Japan. On the other hand, the Japanese encephalitis virus (JEV) transmission cycle still exists, as does the risk of exposure to JEV infection. Although Culex tritaeniorhynchus has been considered the major mosquito vector in Japan, recent surveys suggested Culex pipiens complex and Aedes albopictus as potential alternatives. Similarly, swine have reduced the role in amplification of JEV in paradomestic environments. Another surveys suggested attenuation of recent JEV strains and a shift in the major clinical manifestation caused by JEV infection from encephalitis to meningitis. This paper describes current situation of Japanese encephalitis in Japan from clinical and epidemiological aspects.

Aedes↗
PubMed2006

Pseudotyped viruses permit rapid detection of neutralizing antibodies in human and equine serum against Venezuelan equine encephalitis virus.

Virus envelope proteins are the primary targets of neutralizing antibody responses. The epitopes recognized differ sufficiently between virus subtypes and species to distinguish viruses and provide an important basis for disease diagnosis. Venezuelan equine encephalitis virus (VEEV) causes acute febrile illness in humans and has high mortality in equines. The most specific detection methods for serum antibodies use live virus in neutralization assays or in blocking enzyme linked immunosorbent assays. However, work with Venezuelan equine encephalitis virus requires biosafety level 3 containment and select agent security in the United States. We report two new assays for detection of Venezuelan equine encephalitis virus neutralizing antibody responses, based on virus pseudotypes. The first provides detection by marker gene expression after 20 hours and is particularly suited for high-throughput screening; the second uses a new, rapid virus entry assay to give readouts within 1 hour. Both assays are safe, sensitive, and in general recapitulate neutralizing antibody titers obtained by conventional plaque reduction assays. Each is suitable as a rapid primary screen for detection of neutralizing antibodies against Venezuelan equine encephalitis virus.

Analysis of Variance↗
PubMed1976

[Encephalitis (predilectiveness and "slow" infections)].

Chronic progressive forms of encephalitis (epidemic Economo, tick-borne) are considered from the concept of "slow infections" where the virus following the acute phase of the disease, in the latent state during many years, is persistent in the human organism. The author attributes herpetic encephalitis to this group of disorders. Unlike the slow, gradually developing forms of encephalitis and diseases with a protracted incubational period, herpetical encephalitis develops acutely and may be allocated to "slow infections" in respect to a protracted infection with a long-term persistent virus in the latent condition.

Encephalitis↗