ABSTRACT
The reactivation of human herpesvirus 6 (HHV-6) in patients with AIDS can result in an acute and severe diffuse meningoencephalitis. We describe the epidemiological, clinical and outcome findings of five patients with diagnosis of HIV/AIDS and central nervous system involvement (CNS) due to HHV-6. Fever was present in all the patients. Meningeal compromise, seizures and encephalitis were present in some of the patients. Polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) specimens was positive for HHV-6 in all the patients. HHV-6 should be included among opportunistic and emerging pathogens that involve the CNS in patients with AIDS.
A reativação do herpesvírus humano 6 (HHV-6), em um hospedeiro com AIDS, pode resultar em meningoencefalite aguda difusa. Nós descrevemos a epidemiologia, a clínica e resultados encontrados em cinco pacientes com diagnóstico de HIV/AIDS e comprometimento do sistema nervoso central (SNC) devido ao HHV-6. Todos os pacientes apresentaram febre. Sinais e sintomas de comprometimento meníngeo, convulsões e encefalite podem ser encontrados. A reação em cadeia da polimerase (PCR) de amostras do líquor foi positiva para HHV-6 em todos os pacientes. O HHV-6 deve ser incluído entre os patógenos emergentes oportunistas que comprometem o SNC de pacientes com AIDS.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , AIDS-Related Opportunistic Infections/virology , Communicable Diseases, Emerging/virology , Herpesviridae Infections/virology , /genetics , Meningoencephalitis/virology , AIDS-Related Opportunistic Infections/cerebrospinal fluid , Communicable Diseases, Emerging/cerebrospinal fluid , Herpesviridae Infections/cerebrospinal fluid , Meningoencephalitis/cerebrospinal fluid , Polymerase Chain ReactionABSTRACT
Herpesvirus isolation from cerebrospinal fluid (CSF) has proven not to be very useful because of its low sensitivity; that is the reason why PCR has considerably improved the diagnosis of several viral infections of the central nervous system. We studied, by means of PCR, 253 CSF received in our laboratory from 1996 to 1998, which had a suspected diagnosis of herpesviral-associated neurologic disease (encephalitits or meningoencephalitis). Of these, 182 were from HIV seropositive patients and the other 71 were from HIV seronegative. The percentage of all positive cases was 22.5 in AIDS patients and CMV was the virus most frequently detected (13.7). We detected a percentage of 29.5 of positive cases in immunocompetent individuals, being HSV the virus most frequently found. Other herpesviruses (varicella-zoster virus, Epstein-Barr virus, human herpesvirus 6) were also detected in some cases in both groups. Finally, we obtained clinical data from all positive patients and established a relationship with PCR results.
Subject(s)
Humans , Male , Female , Child , Adult , Herpesviridae Infections , Meningoencephalitis , Cuba , Herpesviridae Infections/cerebrospinal fluid , MeningoencephalitisABSTRACT
Objetivo: Apresentar o relato de um caso de esclerose lateral amiotrófica (ELA). Caso: Homem de 47 anos que apresentava déficit de força nos membros superiores evoluindo há 4 anos. A eletroneuromiografia era compatível a ELA, forma de Vulpian-Bernardt. O estudo do líquido cefalorraqueano (LCR) mostrava processo inflamatório e positividade das reaçoes para Herpes vírus I e II. O estudo do LCR, do soro sanguíneo e da barreira hemato-encefálica sugeria imunoproduçao local para Herpes vírus tipo I. A ressonância nuclear magnética sugeria mielopatia cística ou seringomielia em medula cervical estendendo-se nos espaços C2 a C4. O paciente foi tratado com aciclovir endovenoso por 21 dias. Até dois meses após, o paciente nao foi submetido a novos exames subsidiários para controle. Discussao: Até o momento atual, a doença ELA nao tem tratamento medicamentoso específico. A noçao da existência de "síndrome esclerose lateral amiotrófica" associada a etiologias diversas pode contribuir para o tratamento de alguns doentes.