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Campana V, Inizan C, Pommier JD, Menudier LY, Vincent M, Lecuit M, Lamballerie XD, Dupont-Rouzeyrol M, Murgue B, Cabié A. Liver involvement in dengue: A systematic review. Rev Med Virol 2024; 34:e2564. [PMID: 38923215 DOI: 10.1002/rmv.2564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Liver involvement is an unusual yet frequently overlooked dengue complication. Pivotal for an efficient clinical management, the early diagnosis of dengue-associated liver involvement relies on an accurate description of its clinical and biological characteristics, its prognosis factors, its association with severe dengue and its clinical management. We conducted a systematic review by searching PubMed and Web of Science databases for original case reports, cohort and cross-sectional studies reporting the clinical and/or biological features of dengue-associated liver involvement. The study was registered in PROSPERO (CRD42021262657). Of the 2552 articles identified, 167 were included. Dengue-associated liver involvement was characterised by clinical features including abdominal pain, hepatomegaly, jaundice, nausea/vomiting, and an echogenic liver exhibiting hepatocellular necrosis and minimal inflammation. Elevated Aspartate Aminotransferase and Alanine Aminotransferase but also elevated bilirubin, Alkaline Phosphatase, gamma-glutamyl transferase, increased International Normalised Ratio, creatinine and creatine kinase, lower albumin and prolonged prothrombin and activated partial thromboplastin time were prevalent in dengue-associated liver involvement. Cardiovascular and haematological systems were frequently affected, translating in a strong association with severe dengue. Liver involvement was more common in males and older adults. It was associated with dengue virus serotype-2 and secondary infections. Early paracetamol intake increased the risk of liver involvement, which clinical management was mostly conservative. In conclusion, this systematic review demonstrates that early monitoring of transaminases, clinical assessment, and ultrasound examination allow an efficient diagnosis of dengue-associated liver involvement, enabling the early identification and management of severe dengue.
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Affiliation(s)
- Valentine Campana
- CIC Antilles Guyane, INSERM CIC1424, Fort-de-France, France
- PCCEI, Université de Montpellier, INSERM, Etablissement Français du Sang, Université des Antilles, Montpellier, France
| | - Catherine Inizan
- Unité Dengue et Arboviroses, Institut Pasteur de Nouvelle-Calédonie, Pasteur Network, 110, Boulevard Joseph Wamytan, Dumbéa-sur-Mer, Noumea, New Caledonia
| | - Jean-David Pommier
- Intensive Care Unit, Guadeloupe Teaching Hospital, Antilles - Guyane University, Chemin de Chauvel, Les Abymes, France
| | | | | | - Marc Lecuit
- Institut Pasteur, Université Paris Cité, Inserm U1117, Biology of Infection Unit, Paris, France
- Necker-Enfants Malades University Hospital, Department of Infectious Diseases and Tropical Medicine, APHP, Paris, France
| | - Xavier De Lamballerie
- Unité des Virus Emergents (UVE: Aix-Marseille Université - IRD 190 - Inserm 1207), Marseille, France
| | - Myrielle Dupont-Rouzeyrol
- Unité Dengue et Arboviroses, Institut Pasteur de Nouvelle-Calédonie, Pasteur Network, 110, Boulevard Joseph Wamytan, Dumbéa-sur-Mer, Noumea, New Caledonia
| | - Bernadette Murgue
- Unité des Virus Emergents (UVE: Aix-Marseille Université - IRD 190 - Inserm 1207), Marseille, France
| | - André Cabié
- CIC Antilles Guyane, INSERM CIC1424, Fort-de-France, France
- PCCEI, Université de Montpellier, INSERM, Etablissement Français du Sang, Université des Antilles, Montpellier, France
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Tovani-Palone MR, Bistagnino F, Antonino JR, Subramanian A. Possible role of artificial intelligence in diagnosis of cases with non-specific signs and symptoms of dengue: A comment. Clinics (Sao Paulo) 2024; 79:100388. [PMID: 38754223 PMCID: PMC11126762 DOI: 10.1016/j.clinsp.2024.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Marcos Roberto Tovani-Palone
- Department of Pharmacy and Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chennai, India.
| | - Filippo Bistagnino
- Department of Medical Biotechnology and Translational Medicine, International Medical School, Università degli Studi di Milano, Milan, Italy
| | - Jacopo Rosso Antonino
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Arunkumar Subramanian
- Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chennai, India
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Syed F, Arif MA, Mansoor VB, Usman M, Arif SA. Evolving Spectrum of Dengue: A Two-Year Experience From a Tertiary Care Hospital in Pakistan. Cureus 2024; 16:e53817. [PMID: 38332997 PMCID: PMC10851030 DOI: 10.7759/cureus.53817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE This study focused on examining the clinical manifestations, disease severity, and outcomes among cases of dengue fever (DF) confirmed through serological testing. The study specifically targeted individuals admitted to a tertiary care hospital in Islamabad, Pakistan. METHODOLOGY This prospective observational study at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, tracked 1,003 patients from admission to discharge or death between August 2022 and November 2023. Patients were monitored, and admission criteria were established based on the identification of warning signs. The data collection process encompassed gathering demographic information, documenting clinical symptoms, and utilizing a severity classification system for the disease. Outcome measures comprised the duration of critical illness, length of hospital stay, overall outcomes (discharge or mortality), and the assessment of complications. The collected data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) software version 22.0 (IBM Corp., Armonk, NY). RESULTS Baseline characteristics revealed a male predominance (67.8%), with an average age of 35.77 years, and common comorbidities such as hypertension (9.3%) and diabetes mellitus (7.3%). Dengue fever was most prevalent among patients whose blood group was B+ (15.0%). Nonstructural protein 1 (NS1) was positive in 73.4% of the cases. Fever was the predominant complaint in 98.0% of instances. Common bleeding manifestations included epistaxis, gum bleeding, and hematemesis. About 52.20% of cases were observed to have severe thrombocytopenia at admission. Hospital-related aspects demonstrated a mean stay of 3.35 days, a critical phase lasting 1.68 days, and rare complications like expanded dengue syndrome (2.2%). Encouragingly, 98.9% of patients were discharged, 0.4% were shifted, and 0.7% succumbed to the disease. CONCLUSION This study comprehensively analyzes the demographic and clinical aspects of DF, emphasizing a male predominance and the fact that fever was the most common presenting complaint. The duration of hospitalization revealed a brief mean stay, a short critical phase, and low complication rates, with a high discharge rate suggesting positive outcomes.
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Affiliation(s)
- Fibhaa Syed
- Internal Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
- Internal Medicine, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Mohammad Ali Arif
- Internal Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
- Internal Medicine, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Valeed B Mansoor
- Internal Medicine, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Muhammad Usman
- Internal Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
| | - Saba Ali Arif
- Ophthalmology, Pakistan Institute of Medical Sciences, Islamabad, PAK
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Mustafa MI, Makhawi AM. The reemergence of dengue virus in Sudan. J Infect Public Health 2023; 16:1392-1395. [PMID: 37473544 DOI: 10.1016/j.jiph.2023.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/02/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Dengue fever (DF) is a mosquito-transmitted arboviral disease caused by 1 of 4 closely related but antigenically distinct serotypes of dengue virus (DENV), DENV-1-4. The primary vector of DENV is Aedes aegypti and Aedes albopictus mosquitoes. Humans are the main carrier of the virus and the amplifying host with non-human primates plays a considerable role in sylvatic cycle. On November 8, 2022, an outbreak of dengue fever has killed at least five people in North Kordofan State. On 23 Nov 2022, the Sudanese Ministry of Health reported 3326 cases of dengue fever across 8 Sudanese States; while 23 patients died from the fever. Sudan is witnessing its worst outbreak of dengue fever in over a decade, especially in North and South Kordofan and Red Sea State are hit hard. In this review, we will focus on the recent outbreak of dengue fever in many Sudanese states.
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Affiliation(s)
- Mujahed I Mustafa
- Department of Biotechnology, College of Applied and Industrial Sciences, University of Bahri, Khartoum, Sudan.
| | - Abdelrafie M Makhawi
- Department of Biotechnology, College of Applied and Industrial Sciences, University of Bahri, Khartoum, Sudan
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Clinical and Laboratory Characteristics of Hemophagocytic Lymphohistiocytosis in Children With Severe Dengue During the 2019-2020 Outbreak in Southern Colombia. Pediatr Infect Dis J 2023; 42:e204-e211. [PMID: 36916863 DOI: 10.1097/inf.0000000000003887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is characterized by uncontrolled activation of inflammatory cells and an exaggerated release of cytokines. It can be triggered by different factors, including viruses, such as dengue. The objective of this study was to characterize the clinical and laboratory profiles of children with severe dengue and HLH, and to identify the risk factors for this clinical complication. METHODS An analytical study was conducted in children with severe dengue who were treated in an intensive care unit between January 2019 and March 2020. Clinical and laboratory factors were compared between patients with and without HLH. RESULTS HLH represented 13.4% (15/112) of children with severe dengue. Patients with HLH had a long-lasting fever (10.1 vs. 5.8 days; P = 0.012), low hemoglobin levels (7.6 vs. 10.8 g/dL; P = 0.000) and high aspartate aminotransferase values (4443 vs. 1061 U/L; P = 0.002), alanine transaminase (1433 vs. 487 U/L; P = 0.004), partial thromboplastin time (80.6 vs. 51.8 seconds; P = 0.010), prothrombin time (23.5 vs. 19.6 seconds; P = 0.024), triglycerides (333.7 vs. 223.2 mg/dL; P = 0.005), lactate dehydrogenase (4209 vs. 1947 U/L; P = 0.006), soluble CD25 (3488 vs. 1026 pg/mL; P = 0.014), and presented with higher frequency of myocarditis (66.7% vs. 38.3%; P = 0.048), hepatitis (5.3% vs. 1.3%; P = 0.014), bacterial coinfection (73.3% vs. 26.7%; P = 0.010) and fatal outcome (26% vs. 5%; P = 0.037). CONCLUSIONS HLH is a serious life-threatening clinical complication of dengue virus infection that must be considered, particularly during outbreaks.
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Costa DMDN, Gouveia PADC, Silva GEDB, Neves PDMDM, Vajgel G, Cavalcante MAGDM, Oliveira CBLD, Valente LM, Silveira VMD. The relationship between chikungunya virus and the kidneys: A scoping review. Rev Med Virol 2023; 33:e2357. [PMID: 35521644 DOI: 10.1002/rmv.2357] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 01/28/2023]
Abstract
Several atypical forms of chikungunya fever (CHIK) have been described, including neurological, cardiac and renal involvement. These forms may be related to high morbidity and mortality rates. This scoping review based on the PubMed, Scopus, and WOS databases aims to identify and summarise all the available evidence regarding the clinical and histopathological presentations and risk factors associated with kidney injury related to CHIK, as well as the clinical impact. Thus, a total of 54 papers were selected from 1606 initial references after applying the defined inclusion criteria. Data on the association between kidney injury and CHIK are scarce, with studies only conducted in the acute phase of the disease, lacking further characterisation. Kidney injury incidence in hospitalised patients using the Kidney Disease Improving Global Outcomes criteria varies from 21% to 45%, being higher among patients with atypical and severe manifestations. Although acute kidney injury does not seem to be related to viraemia, it may be related to higher mortality. Few studies have described the renal histopathological changes in the acute phase of CHIK, with prevalent findings of acute interstitial nephritis with mononuclear infiltrate, glomerular congestion and nephrosclerosis. Only one study assessed the kidney function of patients in the subacute and chronic phases of CHIK. Additionally, individuals with comorbidities, including chronic kidney disease, may be among those with a greater risk of presenting worse outcomes when affected by CHIK. The results described herein may contribute to better understand the relationship between the kidneys and chikungunya virus.
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Affiliation(s)
| | | | | | - Precil Diego Miranda de Menezes Neves
- Nephrology Division, University of São Paulo School of Medicine, São Paulo, Brazil.,Nephrology and Dialysis Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Gisele Vajgel
- Nephrology Division, Federal University of Pernambuco, Recife, Brazil
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Wang DP, Wang MY, Li YM, Shu W, Cui W, Jiang FY, Zhou X, Wang WM, Cao JM. Crystal structure of the Ilheus virus helicase: implications for enzyme function and drug design. Cell Biosci 2022; 12:44. [PMID: 35428322 PMCID: PMC9012436 DOI: 10.1186/s13578-022-00777-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/26/2022] [Indexed: 11/19/2022] Open
Abstract
Background The Ilheus virus (ILHV) is an encephalitis associated arthropod-borne flavivirus. It was first identified in Ilheus City in the northeast Brazil before spreading to a wider geographic range. No specific vaccines or drugs are currently available for the treatment of ILHV infections. The ILHV helicase, like other flavivirus helicases, possesses 5ʹ-triphosphatase activity. This allows it to perform ATP hydrolysis to generate energy as well as sustain double-stranded RNA’s unwinding during ILHV genome replication. Thus, ILHV helicase is an ideal target for inhibitor design. Results We determined the crystal structure of the ILHV helicase at 1.75-Å resolution. We then conducted molecular docking of ATP-Mn2+ to the ILHV helicase. Comparisons with related flavivirus helicases indicated that both the NTP and the RNA-ILHV helicase binding sites were conserved across intra-genus species. This suggested that ILHV helicase adopts an identical mode in recognizing ATP/Mn2+. However, the P-loop in the active site showed a distinctive conformation; reflecting a different local structural rearrangement. ILHV helicase enzymatic activity was also characterized. This was found to be relatively lower than that of the DENV, ZIKV, MVE, and ALSV helicases. Our structure-guided mutagenesis revealed that R26A, E110A, and Q280A greatly reduced the ATPase activities. Moreover, we docked two small molecule inhibitors of DENV helicase (ST-610 and suramin) to the ILHV helicase and found that these two molecules had the potential to inhibit the activity of ILHV helicase as well. Conclusion High-resolution ILHV helicase structural analysis demonstrates the key amino acids of ATPase activities and could be useful for the design of inhibitors targeting the helicase of ILHV. Supplementary Information The online version contains supplementary material available at 10.1186/s13578-022-00777-8.
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An autonomous cycle of data analysis tasks for the clinical management of dengue. Heliyon 2022; 8:e10846. [PMID: 36203901 PMCID: PMC9529583 DOI: 10.1016/j.heliyon.2022.e10846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/11/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
Dengue is the most widespread vector-borne disease worldwide. Timely diagnosis and treatment of dengue is the main objective of medical professionals to decrease mortality rates. In this paper, we propose an autonomous cycle that integrates data analysis tasks to support decision-making in the clinical management of dengue. Particularly, the autonomous cycle supports dengue diagnosis and treatment. The proposed system was built using machine learning techniques for classification tasks (artificial neural networks and support vector machines) and evolutionary techniques (a genetic algorithm) for prescription tasks (treatment). The system was quantitatively evaluated using dengue-patient datasets reported by healthcare institutions. Our system was compared with previous works using qualitative criteria. The proposed system has the ability to classify a patient's clinical picture and recommend the best treatment option. In particular, the classification of dengue was done with 98% accuracy and a genetic algorithm recommends treatment options for particular patients. Finally, our system is flexible and easily adaptable, which will allow the addition of new tasks for dengue analysis.
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Vijay J, Anuradha N, Anbalagan VP. Clinical Presentation and Platelet Profile of Dengue Fever: A Retrospective Study. Cureus 2022; 14:e28626. [PMID: 36196330 PMCID: PMC9524240 DOI: 10.7759/cureus.28626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
Background: Dengue fever (DF) is a mosquito-borne viral illness carried worldwide by Aedes aegypti and Aedes albopictus mosquitoes. The aim of the present study was to observe the different clinical presentations of dengue fever and the platelet profile analysis in DF patients. Methods: This retrospective study was performed on 130 diagnosed patients with dengue fever, aged over 14 years. Data collection included patient age, gender, clinical manifestations, hematocrit, platelet count, and evidence of plasma leakage. Results: Most of the patients belong to the 21-30 year age group, with a greater number of males compared to females. The common presentation of dengue fever was fever and myalgia, observed in 100% and 95.3% of the patients, respectively. A platelet count of less than 1,00,000 was observed in 77% of patients, whereas decreased total leukocyte count (TLC) and hematocrit were observed in 52.3% and 40% of patients, respectively. About 46.15% of patients had bradycardia on examination. Pleural effusion and ascites were found in 20.7% and 15.3% of patients, respectively. Conclusion: Patients presenting with fever, hemorrhagic symptoms, or signs of plasma leakage should be promptly suspected, timely diagnosed and managed on the grounds of dengue fever.
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Milhim BHGA, da Rocha LC, Terzian ACB, Mazaro CCP, Augusto MT, Luchs A, Zini N, Sacchetto L, dos Santos BF, Garcia PHC, Rocha RS, Liso E, Brienze VMS, da Silva GCD, Vasilakis N, Estofolete CF, Nogueira ML. Arboviral Infections in Neurological Disorders in Hospitalized Patients in São José do Rio Preto, São Paulo, Brazil. Viruses 2022; 14:1488. [PMID: 35891468 PMCID: PMC9323204 DOI: 10.3390/v14071488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Arbovirus infections are increasingly important causes of disease, whose spectrum of neurological manifestations are not fully known. This study sought to retrospectively assess the incidence of arboviruses in cerebrospinal fluid samples of patients with neurological symptoms to inform diagnosis of central and peripheral nervous system disorders. A total of 255 cerebrospinal fluid (CSF) samples collected from January 2016 to December 2017 were tested for dengue virus (DENV 1-4), Zika virus (ZIKV), and Chikungunya virus (CHIKV) in addition to other neurotropic arboviruses of interest, using genetic and serologic assays. Of the 255 CSF samples analyzed, 3.53% (09/255) were positive for arboviruses presenting mainly as meningitis, encephalitis, and cerebrovascular events, of which ZIKV was detected in 2.74% (7/255), DENV in 0.78% (2/255), in addition to an identified ILHV infection that was described previously. All the cases were detected in adults aged 18 to 74 years old. Our findings highlight the scientific and clinical importance of neurological syndromes associated with arboviruses and demonstrate the relevance of specific laboratory methods to achieve accurate diagnoses as well as highlight the true dimension of these diseases to ultimately improve public health planning and medical case management.
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Affiliation(s)
- Bruno H. G. A. Milhim
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Leonardo C. da Rocha
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Ana C. B. Terzian
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
- Laboratório de Imunologia Celular e Molecular (LICM), Avenida Augusto de Lima, 1715, Centro, Belo Horizonte 30190-002, MG, Brazil
- Instituto René Rachou Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Centro, Belo Horizonte 30190-002, MG, Brazil
| | - Carolina C. P. Mazaro
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Marcos T. Augusto
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Adriana Luchs
- Enteric Disease Laboratory, Department of Virology, Adolfo Lutz Institute, Avenida Dr. Arnaldo, 355, São Paulo 01246-902, SP, Brazil;
| | - Nathalia Zini
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Livia Sacchetto
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Barbara F. dos Santos
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Pedro H. C. Garcia
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Rodrigo S. Rocha
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Elisabete Liso
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544-Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (E.L.); (V.M.S.B.)
| | - Vânia M. S. Brienze
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544-Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (E.L.); (V.M.S.B.)
| | - Gislaine C. D. da Silva
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA;
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX 77555-1150, USA
- Center for Vector-Borne and Zoonotic Diseases, The University of Texas Medical Branch, Galveston, TX 77555-0609, USA
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA
| | - Cássia F. Estofolete
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
| | - Maurício L. Nogueira
- Laboratório de Pesquisas em Virologia [LPV], Faculdade de Medicina de São José do Rio Preto [FAMERP], Avenida Brigadeiro Faria Lima, 5544, Vila São Jose, São José do Rio Preto 15090-000, SP, Brazil; (B.H.G.A.M.); (L.C.d.R.); (A.C.B.T.); (C.C.P.M.); (M.T.A.); (N.Z.); (L.S.); (B.F.d.S.); (P.H.C.G.); (R.S.R.); (G.C.D.d.S.); (C.F.E.)
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA;
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11
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Leowattana W, Leowattana T. Dengue hemorrhagic fever and the liver. World J Hepatol 2021; 13:1968-1976. [PMID: 35070001 PMCID: PMC8727196 DOI: 10.4254/wjh.v13.i12.1968] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/06/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
Dengue hemorrhagic fever (DHF) is one of the most rapidly emerging infections of tropical and subtropical regions worldwide. It affects more rural and urban areas due to many factors, including climate change. Although most people with dengue viral infection are asymptomatic, approximately 25% experience a self-limited febrile illness with mild to moderate biochemical abnormalities. Severe dengue diseases develop in a small proportion of these patients, and the common organ involvement is the liver. The hepatocellular injury was found in 60%-90% of DHF patients manifested as hepatomegaly, jaundice, elevated aminotransferase enzymes, and critical condition as an acute liver failure (ALF). Even the incidence of ALF in DHF is very low (0.31%-1.1%), but it is associated with a relatively high mortality rate (20%-68.3%). The pathophysiology of liver injury in DHF included the direct cytopathic effect of the DENV causing hepatocytes apoptosis, immune-mediated hepatocyte injury induced hepatitis, and cytokine storm. Hepatic hypoperfusion is another contributing factor in dengue shock syndrome. The reduction of morbidity and mortality in DHF with liver involvement is dependent on the early detection of warning signs before the development of ALF.
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Affiliation(s)
- Wattana Leowattana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Bangkok, Thailand
| | - Tawithep Leowattana
- Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Bangkok, Thailand
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12
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Jácome FC, Caldas GC, Rasinhas ADC, de Almeida ALT, de Souza DDC, Paulino AC, da Silva MAN, Bandeira DM, Barth OM, dos Santos FB, Barreto-Vieira DF. Immunocompetent Mice Infected by Two Lineages of Dengue Virus Type 2: Observations on the Pathology of the Lung, Heart and Skeletal Muscle. Microorganisms 2021; 9:microorganisms9122536. [PMID: 34946137 PMCID: PMC8704795 DOI: 10.3390/microorganisms9122536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
Dengue virus (DENV) infection by one of the four serotypes (DENV-1 to 4) may result in a wide spectrum of clinical manifestations, with unpredictable evolution and organ involvement. Due to its association with severe epidemics and clinical manifestations, DENV-2 has been substantially investigated. In fact, the first emergence of a new lineage of the DENV-2 Asian/American genotype in Brazil (Lineage II) in 2008 was associated with severe cases and increased mortality related to organ involvement. A major challenge for dengue pathogenesis studies has been a suitable animal model, but the use of immune-competent mice, although sometimes controversial, has proven to be useful, as histological observations in infected animals reveal tissue alterations consistent to those observed in dengue human cases. Here, we aimed to investigate the outcomes caused by two distinct lineages of the DENV-2 Asian/American genotype in the lung, heart and skeletal muscle tissues of infected BALB/c mice. Tissues were submitted to histopathology, immunohistochemistry, histomorphometry and transmission electron microscopy (TEM) analysis. The viral genome was detected in heart and skeletal muscle samples. The viral antigen was detected in cardiomyocytes and endothelial cells of heart tissue. Heart and lung tissue samples presented morphological alterations comparable to those seen in dengue human cases. Creatine kinase serum levels were higher in mice infected with both lineages of DENV-2. Additionally, statistically significant differences, concerning alveolar septa thickening and heart weight, were observed between BALB/c mice infected with both DENV-2 lineages, which was demonstrated to be an appropriate experimental model for dengue pathogenesis studies on lung, heart and skeletal muscle tissues.
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Affiliation(s)
- Fernanda Cunha Jácome
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
- Correspondence:
| | - Gabriela Cardoso Caldas
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Arthur da Costa Rasinhas
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Ana Luisa Teixeira de Almeida
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Daniel Dias Coutinho de Souza
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Amanda Carlos Paulino
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Marcos Alexandre Nunes da Silva
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Derick Mendes Bandeira
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Ortrud Monika Barth
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
| | - Flavia Barreto dos Santos
- Laboratory of Viral Immunology, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil;
| | - Debora Ferreira Barreto-Vieira
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21040-900, Brazil; (G.C.C.); (A.d.C.R.); (A.L.T.d.A.); (D.D.C.d.S.); (A.C.P.); (M.A.N.d.S.); (D.M.B.); (O.M.B.); (D.F.B.-V.)
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13
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Cunha MDP, Duarte-Neto AN, Pour SZ, Hajjar LA, Frassetto FP, Dolhnikoff M, Saldiva PHDN, Zanotto PMDA. Systemic dengue infection associated with a new dengue virus type 2 introduction in Brazil - a case report. BMC Infect Dis 2021; 21:311. [PMID: 33794785 PMCID: PMC8015031 DOI: 10.1186/s12879-021-05959-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dengue infection is caused by an arbovirus with a wide range of presentations, varying from asymptomatic disease to unspecific febrile illness and haemorrhagic syndrome with shock, which can evolve to death. In Brazil, the virus circulates since the 1980s with many introductions of new serotypes, genotypes, and lineages since then. Here we report a fatal case of dengue associated with a Dengue virus (DENV) lineage not detected in the country until now. CASE PRESENTATION The patient, a 58-year-old man arrived at the hospital complaining of fever and severe abdominal pain due to intense gallbladder edema, mimicking acute abdomen. After 48 h of hospital admission, he evolved to refractory shock and death. DENV RNA was detected in all tissues collected (heart, lung, brain, kidney, spleen, pancreas, liver, and testis). Viral sequencing has shown that the virus belongs to serotype 2, American/Asian genotype, in a new clade, which has never been identified in Brazil before. The virus was phylogenetically related to isolates from central America [Puerto Rico (2005-2007), Martinique (2005), and Guadeloupe (2006)], most likely arriving in Brazil from Puerto Rico. CONCLUSION In summary, this was the first fatal documented case with systemic dengue infection associated with the new introduction of Dengue type 2 virus in Brazil during the 2019 outbreak.
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Affiliation(s)
- Marielton Dos Passos Cunha
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.
| | | | - Shahab Zaki Pour
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil
| | - Ludhmila Abrahão Hajjar
- Intensive Care Unit, Heart Institute (InCor), Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Marisa Dolhnikoff
- Pathology Department, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Paolo Marinho de Andrade Zanotto
- Laboratory of Molecular Evolution and Bioinformatics, Department of Microbiology, Biomedical Sciences Institute, University of São Paulo, São Paulo, Brazil.
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Frota LAA, Santos NC, Ferreira GP, da Silva FRP, Pereira ACTDC. What is the association between the IL6-174 G > C (rs1800795) polymorphism and the risk of dengue? Evidence from a meta-analysis. INFECTION GENETICS AND EVOLUTION 2021; 91:104778. [PMID: 33662586 DOI: 10.1016/j.meegid.2021.104778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/29/2021] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
The association of polymorphisms in genes responsible for immunological mediators with dengue allows the identification of certain genetic alterations that increase or decrease the development risk of the disease. A few number of studies that correlate the interleukin 6-174 G > C (IL6-174 G > C) polymorphism (rs1800795) with dengue. However, there is an inconsistency on the polymorphism influence on the disease which motivated this meta-analysis. So, this study aimed to evaluate the rs1800795 polymorphism with protection or susceptibility for development of dengue. A search of the literature was performed for studies published before 05 September 2020 in various databases. Calculations of Odds Ratio (OR) with 95% of Confidence Intervals (CI) and heterogeneity (I2) were assessed and publication bias was done by Begg' and Egger's test. The value of P < 0.05 was considered as significant. As results, five case-control studies were identified and included in the results. The analysis showed that the heterozygous genotype has a protective role against dengue without warning signs (DWOS) (OR = 0.57, p = 0.001), as well as the polymorphic C allele (OR = 0.77, p = 0.04). When unifying the data from the included studies, the GG genotype was more prevalent among individuals with dengue with warning signs (DWWS) when compared to the control group (p = 0.0221). GC genotype was more prevalent in the control group than in the DWWS group (p = 0.0119). Therefore, in our study we observed that the GC genotype and the C allele have a protective role against DWOS. Since this polymorphism is associated with low IL-6 expression, thus it is expected that there will be a decreased pro-inflammatory response. However, more studies regarding this thematic are necessary to have a consensus about this polymorphism and dengue.
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Affiliation(s)
- Lineker Alberto Araújo Frota
- Laboratory of Biology of Microorganisms, Universidade Federal do Delta do Parnaíba, Campus Ministro Reis Velloso, Parnaíba, Piauí, Brazil
| | - Naiany Carvalho Santos
- Laboratory of Biology of Microorganisms, Universidade Federal do Delta do Parnaíba, Campus Ministro Reis Velloso, Parnaíba, Piauí, Brazil; Programa de Pós-graduação em Ciências Biomédicas da Universidade Federal do Delta do Parnaíba, Laboratório de Biologia de Microrganismos - BIOMIC, Av. São Sebastião, 2819, Bairro Reis Velloso, CEP 64202-020, Parnaíba - PI, Brasil
| | - Gustavo Portela Ferreira
- Laboratory of Biology of Microorganisms, Universidade Federal do Delta do Parnaíba, Campus Ministro Reis Velloso, Parnaíba, Piauí, Brazil; Programa de Pós-graduação em Ciências Biomédicas da Universidade Federal do Delta do Parnaíba, Laboratório de Biologia de Microrganismos - BIOMIC, Av. São Sebastião, 2819, Bairro Reis Velloso, CEP 64202-020, Parnaíba - PI, Brasil
| | | | - Anna Carolina Toledo da Cunha Pereira
- Laboratory of Biology of Microorganisms, Universidade Federal do Delta do Parnaíba, Campus Ministro Reis Velloso, Parnaíba, Piauí, Brazil; Programa de Pós-graduação em Ciências Biomédicas da Universidade Federal do Delta do Parnaíba, Laboratório de Biologia de Microrganismos - BIOMIC, Av. São Sebastião, 2819, Bairro Reis Velloso, CEP 64202-020, Parnaíba - PI, Brasil.
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15
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Artal FJC, Araujo AQC. Neurological complications in adults with Zika and chikungunya virus infection. Lancet Neurol 2020; 19:799-801. [PMID: 32949531 DOI: 10.1016/s1474-4422(20)30309-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Francisco Javier Carod Artal
- Neurology Department, Raigmore Hospital, National Health Service Highlands, Inverness IV2 3UJ, UK; Health Science Faculty, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Abelardo Q-C Araujo
- Institute of Neurology, Federal University of Rio de Janeiro, and Laboratory for Clinical Research in Neuroinfections, National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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16
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Milhim BHGA, Estofolete CF, da Rocha LC, Liso E, Brienze VMS, Vasilakis N, Terzian ACB, Nogueira ML. Fatal Outcome of Ilheus Virus in the Cerebrospinal Fluid of a Patient Diagnosed with Encephalitis. Viruses 2020; 12:v12090957. [PMID: 32872425 PMCID: PMC7552055 DOI: 10.3390/v12090957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 01/06/2023] Open
Abstract
Ilheus virus is an arbovirus with the potential for central nervous system involvement. Accurate diagnosis is a challenge due to similar clinical symptoms and serologic cross-reactivity with other flaviviruses. Here, we describe the first documented case of a fatal outcome following the identification of Ilheus virus in the cerebrospinal fluid (CSF) of a patient with cerebral encephalitis in Brazil.
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Affiliation(s)
- Bruno H. G. A. Milhim
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Cássia F. Estofolete
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Leonardo C. da Rocha
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Elisabete Liso
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, SP 15090-000 São José do Rio Preto, Brazil; (E.L.); (V.M.S.B.)
| | - Vânia M. S. Brienze
- Hospital de Base, Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, SP 15090-000 São José do Rio Preto, Brazil; (E.L.); (V.M.S.B.)
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA;
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA
| | - Ana C. B. Terzian
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
| | - Maurício L. Nogueira
- Laboratório de Pesquisas em Virologia (LPV), Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5544 - Vila Sao Jose, 15090-000 São José do Rio Preto, Brazil; (B.H.G.A.M.); (C.F.E.); (L.C.d.R.); (A.C.B.T.)
- Correspondence: ; Tel.: +55-1798811-0550
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17
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Estofolete CF, Milhim BHGA, Zini N, Scamardi SN, Selvante JD, Vasilakis N, Nogueira ML. Flavivirus Infection Associated with Cerebrovascular Events. Viruses 2020; 12:v12060671. [PMID: 32580374 PMCID: PMC7354470 DOI: 10.3390/v12060671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022] Open
Abstract
Arthropod-borne viruses (arboviruses) of the genus Flavivirus are distributed globally and cause significant human disease and mortality annually. Flavivirus infections present a spectrum of clinical manifestations, ranging from asymptomatic to severe manifestations, including hemorrhage, encephalitis and death. Herein, we describe 3 case reports of cerebrovascular involvement in patients infected by dengue and Zika viruses in Sao Jose do Rio Preto, São Paulo State, Brazil, a hyperendemic area for arbovirus circulation, including dengue, yellow fever, chikungunya and Saint Louis encephalitis viruses. Our findings highlight the potential threat that unusual clinical manifestations may pose to arbovirus disease management and recovery.
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Affiliation(s)
- Cássia F Estofolete
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Bruno H G A Milhim
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Nathalia Zini
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Samuel N Scamardi
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Joana D'Arc Selvante
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Center for Tropical Diseases, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609, USA
- Institute for Human Infection and Immunity, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA
| | - Maurício L Nogueira
- Department of Infectious, Dermatological and Parasitic Infections, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
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