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Houldcroft CJ. Human Herpesvirus Sequencing in the Genomic Era: The Growing Ranks of the Herpetic Legion. Pathogens 2019; 8:E186. [PMID: 31614759 PMCID: PMC6963362 DOI: 10.3390/pathogens8040186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 12/19/2022] Open
Abstract
The nine human herpesviruses are some of the most ubiquitous pathogens worldwide, causing life-long latent infection in a variety of different tissues. Human herpesviruses range from mild childhood infections to known tumour viruses and 'trolls of transplantation'. Epstein-Barr virus was the first human herpesvirus to have its whole genome sequenced; GenBank now includes thousands of herpesvirus genomes. This review will cover some of the recent advances in our understanding of herpesvirus diversity and disease that have come about as a result of new sequencing technologies, such as target enrichment and long-read sequencing. It will also look at the problem of resolving mixed-genotype infections, whether with short or long-read sequencing methods; and conclude with some thoughts on the future of the field as herpesvirus population genomics becomes a reality.
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Affiliation(s)
- Charlotte J Houldcroft
- Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambs CB2 0QQ UK.
- Parasites and Microbes, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambs CB10 1SA, UK.
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Underdown SJ, Kumar K, Houldcroft C. Network analysis of the hominin origin of Herpes Simplex virus 2 from fossil data. Virus Evol 2017; 3:vex026. [PMID: 28979799 PMCID: PMC5617628 DOI: 10.1093/ve/vex026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Herpes simplex virus 2 (HSV2) is a human herpesvirus found worldwide that causes genital lesions and more rarely causes encephalitis. This pathogen is most common in Africa, and particularly in central and east Africa, an area of particular significance for the evolution of modern humans. Unlike HSV1, HSV2 has not simply co-speciated with humans from their last common ancestor with primates. HSV2 jumped the species barrier between 1.4 and 3 MYA, most likely through intermediate but unknown hominin species. In this article, we use probability-based network analysis to determine the most probable transmission path between intermediate hosts of HSV2, from the ancestors of chimpanzees to the ancestors of modern humans, using paleo-environmental data on the distribution of African tropical rainforest over the last 3 million years and data on the age and distribution of fossil species of hominin present in Africa between 1.4 and 3 MYA. Our model identifies Paranthropus boisei as the most likely intermediate host of HSV2, while Homo habilis may also have played a role in the initial transmission of HSV2 from the ancestors of chimpanzees to P.boisei.
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Affiliation(s)
- Simon J. Underdown
- Human Origins and Palaeoenvironmental Research Group (HOPE), Department of Anthropology & Geography, Oxford Brookes University, Oxford OX3 0BP, UK
- Leverhulme Centre for Human Evolutionary Studies, University of Cambridge, Henry Wellcome Building, Fitzwilliam Street, Cambridge CB2 1QH, UK
| | - Krishna Kumar
- Computational Geomechanics, Cambridge University Engineering Department, Trumpington Street, Cambridge CB2 1PZ, UK
| | - Charlotte Houldcroft
- Department of Archaeology, University of Cambridge, Cambridge CB2 3QG, UK
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge CB2 3ER, UK
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Houldcroft CJ, Ramond JB, Rifkin RF, Underdown SJ. Migrating microbes: what pathogens can tell us about population movements and human evolution. Ann Hum Biol 2017; 44:397-407. [PMID: 28511559 DOI: 10.1080/03014460.2017.1325515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The biology of human migration can be observed from the co-evolutionary relationship with infectious diseases. While many pathogens are brief, unpleasant visitors to human bodies, others have the ability to become life-long human passengers. The story of a pathogen's genetic code may, therefore, provide insight into the history of its human host. The evolution and distribution of disease in Africa is of particular interest, because of the deep history of human evolution in Africa, the presence of a variety of non-human primates, and tropical reservoirs of emerging infectious diseases. METHODS This study explores which pathogens leave traces in the archaeological record, and whether there are realistic prospects that these pathogens can be recovered from sub-Saharan African archaeological contexts. RESULTS Three stories are then presented of germs on a journey. The first is the story of HIV's spread on the back of colonialism and the railway networks over the last 150 years. The second involves the spread of Schistosoma mansoni, a parasite which shares its history with the trans-Atlantic slave trade and the origins of fresh-water fishing. Finally, we discuss the tantalising hints of hominin migration and interaction found in the genome of human herpes simplex virus 2. CONCLUSIONS Evidence from modern African pathogen genomes can provide data on human behaviour and migration in deep time and contribute to the improvement of human quality-of-life and longevity.
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Affiliation(s)
- Charlotte J Houldcroft
- a Department of Archaeology and Anthropology, Division of Biological Anthropology , University of Cambridge , Cambridge , UK.,b McDonald Institute of Archaeological Research, University of Cambridge , Cambridge , UK
| | - Jean-Baptiste Ramond
- c Department of Genetics , Centre for Microbial Ecology and Genomics, Genomic Research Institute, University of Pretoria , Hatfield , South Africa
| | - Riaan F Rifkin
- c Department of Genetics , Centre for Microbial Ecology and Genomics, Genomic Research Institute, University of Pretoria , Hatfield , South Africa
| | - Simon J Underdown
- d Department of Anthropology & Geography, Human Origins and Palaeoenvironmental Research Group (HOPE) , Oxford Brookes University , Oxford , UK.,e Leverhulme Centre for Human Evolutionary Studies , Henry Wellcome Building , Cambridge , UK
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4
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Maller VV, Bathla G, Moritani T, Helton KJ. Imaging in viral infections of the central nervous system: can images speak for an acutely ill brain? Emerg Radiol 2016; 24:287-300. [DOI: 10.1007/s10140-016-1463-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/02/2016] [Indexed: 12/22/2022]
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Fernandez-Gerlinger M, Greffe S, Meffre A, Grenet J, Au S, Bojanova M, Rouveix E, Rozenberg F. HSV-2 meningoencephalitis in an immunocompetent young man: what is the pathogenesis and what is the treatment? J Clin Virol 2015. [PMID: 26209376 DOI: 10.1016/j.jcv.2015.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Herpes simplex encephalitis is rarely caused by herpes simplex virus type 2 (HSV-2) after the neonatal period. The pathogenesis of HSV-2 encephalitis is not known and its treatment has not been discussed. We report a case of mild meningoencephalitis secondary to HSV-2 primary infection after sexual risk behaviour in a healthy young man. The diagnosis was established upon clinical, biological and electroencephalographic criteria. Aciclovir treatment led to rapid clinical improvement. This case highlights HSV-2 as a rare cause of meningoencephalitis, and questions the management of this rare manifestation of HSV-2 infection.
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Affiliation(s)
- Mp Fernandez-Gerlinger
- Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France; Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
| | - S Greffe
- Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France
| | - A Meffre
- Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France
| | - J Grenet
- Service d'accueil des urgences, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France
| | - S Au
- Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France; Service de réanimation médico-chirurgicale, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France
| | - M Bojanova
- Service de Virologie, Université Paris Descartes & Hôpitaux Universitaires Paris Centre, AP-HP, 75014 Paris, France
| | - E Rouveix
- Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France; Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - F Rozenberg
- Service de Virologie, Université Paris Descartes & Hôpitaux Universitaires Paris Centre, AP-HP, 75014 Paris, France
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Ballaekere JS, Chebbi PP, Sundarmurthy H, Parameshwarappa A. Weber syndrome: herpes simplex virus brainstem encephalitis as an etiology. Am J Med 2014; 127:e5-6. [PMID: 25149428 DOI: 10.1016/j.amjmed.2014.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 07/17/2014] [Accepted: 08/08/2014] [Indexed: 11/16/2022]
Affiliation(s)
| | - Pramod Prahlad Chebbi
- Department of General Medicine, JSS Medical College and Hospital, JSS University, Mysore, India.
| | - Harsha Sundarmurthy
- Department of Neurology, JSS Medical College and Hospital, JSS University, Mysore, India
| | - Ashok Parameshwarappa
- Department of General Medicine, JSS Medical College and Hospital, JSS University, Mysore, India
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Yin S, Li Y, Xia H, Zhao J, Zhang Z, Tang S, Kou Z, Chen J, Yu J, Fan Z, Li T. An improved system for the evaluation of antiviral compounds against herpes simplex virus type 2. J Virol Methods 2013; 189:317-20. [PMID: 23454799 DOI: 10.1016/j.jviromet.2013.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 02/06/2013] [Accepted: 02/13/2013] [Indexed: 11/26/2022]
Abstract
Infection with herpes simplex virus type 2 (HSV-2) can result in lesions in reproductive organs, along with long-term latency. In this work, a non-lethal strain of HSV-2 which was isolated clinically was used to infect female mice intravaginally. Body weight, vulval lesions, histological examination of vaginal tissue, and viral load were monitored and used as indices for evaluating antiviral drugs against HSV-2 infection. The results indicated that mice infected with HSV-2 exhibited significant reduction in body weight, serious vulval lesions, massive lymphocyte invasion of vaginal tissue, and approximately 10⁴ copies/μl of HSV-2 were found in vaginal and uterine tissues. Aciclovir (ACV) treatment inhibited loss in body weight, genital pathology and virus replication (reduced to 10⁰·³ copies/μl) effectively. The study provides a simple, reproducible and feasible animal model for anti-HSV-2 drugs evaluation and HSV-2 vaccine research.
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Affiliation(s)
- Shiyu Yin
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China
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Meyding-Lamadé U, Strank C. Herpesvirus infections of the central nervous system in immunocompromised patients. Ther Adv Neurol Disord 2012; 5:279-96. [PMID: 22973424 DOI: 10.1177/1756285612456234] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Human herpesviruses may cause infections of the central nervous system during primary infection or following reactivation from a latent state. Especially in immunosuppressed patients the infection can take a life-threatening course, and therefore early diagnosis of herpesvirus-associated neurological diseases should have high priority. Clinical presentation in these patients is usually without typical features, making diagnosis even more challenging. Therefore general broad testing for different herpesviruses in cerebrospinal fluid samples is highly recommended. In addition, determination of the virus DNA level in the cerebrospinal fluid by quantitative assays seems to be of high importance to determine prognosis. Moreover, it might help to differentiate between specific virus-associated disease and unspecific presence of virus in the cerebrospinal fluid, especially in immunocompromised patients. Polymerase chain reaction analysis of cerebrospinal fluid has revolutionized the diagnosis of nervous system viral infections, particularly those caused by human herpesviruses. This review summarizes the role human herpesviruses play in central nervous system infections in immunocompromised patients, with a focus on the clinical manifestation of encephalitis.
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Affiliation(s)
- Uta Meyding-Lamadé
- Head, Department of Neurology Krankenhaus Nordwest, Frankfurt/M. Germany
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[Brainstem encephalitis in an 8-year-old girl]. Rechtsmedizin (Berl) 2012; 22:172-177. [PMID: 32288295 PMCID: PMC7140227 DOI: 10.1007/s00194-012-0823-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Enzephalitiden sind häufig viral bedingt und können verschiedene Hirnareale betreffen. Ihre klinische Symptomatik ist sehr variabel. Gering symptomatische zerebrale (Begleit-)Infektionen bleiben bisweilen undiagnostiziert. Es können aber auch sehr schwere klinische Symptome (Lähmungen, Krämpfe) auftreten. Vorgestellt wird der Fall eines 8-jährigen Mädchens, das wenige Tage nach einem harmlosen Sturz auf den Hinterkopf zunehmend unter Kopfschmerzen und Erbrechen litt. Der Gesundheitszustand verschlechterte sich rasant und führte 7 Tage nach dem Sturz zur Vorstellung beim Kinderarzt. Nach weiterem foudroyantem Verlauf der Krankheit wurde das Mädchen 2 Tage später unter Krämpfen und pulmonaler Obstruktion in eine Klinik aufgenommen; hier musste es reanimiert werden. Im kranialen Computertomogramm (cCT) stellten sich temporal hypodense Areale und lokale Ödeme dar. Eine Herzechokardiographie ergab eine eingeschränkte linksventrikuläre Pumpfunktion, sodass der Verdacht auf eine Enzephalitis und eine Myokarditis gestellt wurde. Trotz antiviraler und antibiotischer Therapie verstarb das Kind 2 Tage nach Aufnahme in die Klinik an intravitalem Hirntod und Multiorganversagen. Bei der rechtsmedizinischen Sektion fanden sich keine knöchernen kranialen oder intrakranialen Verletzungen oder prädisponierende Erkrankungen. Histologische Untersuchungen ergaben eine nekrotisierende Hirnstammenzephalitis.
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Herpes simplex encephalitis and management of acyclovir in encephalitis patients in France. Epidemiol Infect 2011; 140:372-81. [DOI: 10.1017/s0950268811000483] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYThis study reports on the clinical profiles of herpes simplex encephalitis (HSE) case-patients and the management of acyclovir prescriptions. We designed a study on the causes of encephalitis in France in 2007. Case-patients fulfilling the inclusion criteria were enrolled in all the hospitals that volunteered to participate. Fifty-five of 253 enrolled case-patients were diagnosed with HSE. Three (5%) HSE patients died and 48 (89%) were discharged with persistent neurological symptoms. All HSE patients were prescribed acyclovir, 10 of whom had a 2-week course; 42 a 3-week course; two received incomplete courses; and one received two courses of 21 days each due to relapse. The acyclovir dosage was reported for 45 adult HSE patients, 25 (53%) of whom received 10 mg/kg t.i.d. and 22 (47%) received 15 mg/kg t.i.d. The mortality rate was low despite 49% of patients being admitted to intensive-care units. A high dose of acyclovir was not associated with a better outcome in HSE patients. Most patients had persisting symptoms on discharge suggesting neuropsychological rehabilitation is an important issue for survivors.
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Tang JW, Lin M, Chiu L, Koay ES. Viral loads of herpes simplex virus in clinical samples-A 5-year retrospective analysis. J Med Virol 2010; 82:1911-6. [DOI: 10.1002/jmv.21903] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Herpes simplex type 1 encephalitis restricted to the brainstem in a pediatric patient. Case Rep Med 2010; 2010:606584. [PMID: 20671915 PMCID: PMC2910496 DOI: 10.1155/2010/606584] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 05/30/2010] [Indexed: 11/17/2022] Open
Abstract
Herpes simplex encephalitis is a potentially fatal infection of central nervous system that typically involves frontal and temporal lobes. Occasionally, it presents an extratemporal involvement and in rarer cases, it is limited to the brainstem. We describe a case of an adolescent who presented with fever, sore throat, and vertigo. Clinical picture evolved to lethargy, tetraparesis, consciousness impairment, and respiratory failure. MRI showed lesions restricted to the brainstem. PCR of CSF was positive for herpes simplex type 1.
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Brainstem encephalitis: an unusual presentation of herpes simplex virus infection. J Neurol 2010; 257:1432-7. [PMID: 20495814 DOI: 10.1007/s00415-010-5600-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 05/06/2010] [Accepted: 05/11/2010] [Indexed: 10/19/2022]
Abstract
Herpes simplex virus (HSV) encephalitis has a predilection for the temporal and frontal lobes but occasionally affects the brainstem. We describe a patient who developed HSV brainstem encephalitis that progressed to quadriplegia. Using MEDLINE, we conducted a comprehensive review of other published cases of HSV brainstem encephalitis. Twenty-four published cases of HSV brainstem encephalitis met our inclusion criteria. The mean age was 41.4 years (range 18-71). HSV-1 was the etiologic agent in 79% of reported HSV brainstem encephalitis cases, and HSV-2 accounted for 21% of cases. Infection was limited to the brainstem in 29% of cases and multi-focal, including the brainstem, in 71%. Common manifestations of HSV brainstem encephalitis included neuro-ophthalmologic findings (81%), cranial nerve deficits (69%), and fever (69%). Quadriplegia, as occurred in our patient, was an unusual finding (19%). The mortality rate of HSV brainstem encephalitis was 41%. Intravenous acyclovir showed a beneficial effect on mortality (75% vs. 22%, p = 0.06). HSV brainstem encephalitis is a distinct type of HSV encephalitis. With the increasing use of HSV-PCR, more cases of HSV brainstem encephalitis may be identified. A greater recognition of this syndrome will help better define its optimal treatment and prognosis.
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Miura S, Kurita T, Noda K, Ayabe M, Aizawa H, Taniwaki T. Symmetrical brainstem encephalitis caused by herpes simplex virus. J Clin Neurosci 2009; 16:589-90. [DOI: 10.1016/j.jocn.2008.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 05/29/2008] [Accepted: 06/08/2008] [Indexed: 10/21/2022]
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Abstract
An 85-year-old immunocompetent man was hospitalized following the development of increasing confusion and intermittent disorientation over a 48-hour period. Within 48 hours of hospitalization, he was oriented to person only and was unable to follow commands. There were no focal neurologic deficits. Magnetic resonance imaging of the brain showed extensive perivascular demyelination. Lumbar puncture was performed and showed normal opening pressure. Cerebrospinal fluid analysis showed 8 leukocytes (7 lymphocytes), as well as normal glucose and protein levels. Polymerase chain reaction evaluation of cerebrospinal fluid was positive for herpes simplex virus type 2. He was diagnosed with herpes simplex type 2 encephalitis and is to the authors' knowledge the first elderly immunocompetent patient to be reported with this disorder.
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Hokkanen L, Launes J. Neuropsychological sequelae of acute-onset sporadic viral encephalitis. Neuropsychol Rehabil 2007; 17:450-77. [PMID: 17676530 DOI: 10.1080/09602010601137039] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Acute encephalitis is an inflammation of the brain parenchyma. In the USA, by estimation, 20,000 cases occur every year. A variety of cognitive deficits may persist after the acute stage, and they are often the sole cause of disability. Recent literature demonstrates the heterogeneity of both amnestic disorders and the outcome following encephalitis. Herpes simplex virus is the most commonly recognised single aetiology of sporadic encephalitis and it may be the cause of the most severe symptoms. Antiviral medication, however, seems to have improved the cognitive outcome when compared to the historical, untreated cases. The cognitive sequelae following herpes simplex virus encephalitis (HSVE) are best known and most commonly described, e.g., in textbooks, but they do not represent the typical symptomatology of encephalitis in general. Much less is unfortunately known about other types of encephalitis, those that account perhaps up to 80% of all cases, where both mild and severe defects have been observed. This article summarises the current knowledge.
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Affiliation(s)
- Laura Hokkanen
- University of Helsinki, Department of Psychology, Helsinki, Finland.
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Pelligra G, Lynch N, Miller SP, Sargent MA, Osiovich H. Brainstem involvement in neonatal herpes simplex virus type 2 encephalitis. Pediatrics 2007; 120:e442-6. [PMID: 17671049 DOI: 10.1542/peds.2006-3757] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Herpes simplex virus encephalitis in the newborn typically involves the cerebral cortex in a widespread manner. Herpes simplex virus type 2 rarely involves the brainstem. Here we report a 16-day-old infant with predominant brainstem and cerebellar involvement secondary to herpes simplex virus type 2 infection. Diffusion-weighted MRI performed 3 days after the onset of symptoms revealed restricted diffusion mainly in brainstem and cerebellar structures. No abnormal findings were seen on conventional MRI. Subsequent MRI scans showed evolution of the brain injury with extension along the corticospinal tracts. However, there was no evidence of any other supratentorial gray or white matter injury. This is the first report of predominant brainstem involvement in neonatal herpes simplex virus type 2 encephalitis. In addition, the importance of performing diffusion-weighted sequences to detect early central nervous system involvement and serial MRI to follow the evolution of central nervous system lesions is emphasized.
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Affiliation(s)
- Gustavo Pelligra
- Division of Neonatology, Children's and Women's Health Centre of British Columbia, 4480 Oak St, Vancouver, British Columbia, Canada V6H 3V4
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Omland LH, Vestergaard BF, Wandall JH. Herpes simplex virus type 2 infections of the central nervous system: A retrospective study of 49 patients. ACTA ACUST UNITED AC 2007; 40:59-62. [PMID: 17852910 DOI: 10.1080/00365540701509881] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Herpes simplex virus type 2 (HSV-2) infections of the central nervous system (CNS) are rare with meningitis as the most common clinical presentation. We have investigated the clinical spectrum of CNS infections in 49 adult consecutive patients with HSV-2 genome in the cerebrospinal fluid (CSF). HSV-2 in the CSF was determined by polymerase chain reaction (PCR), and patients were diagnosed as encephalitis or meningitis according to predefined clinical criteria by retrospective data information from consecutive clinical journals. The annual crude incidence rate of HSV-2 CNS disease was 0.26 per 100,000. 43 (88%) had meningitis of whom 8 (19%) had recurring lymphocytic meningitis. Six patients (12%) had encephalitis. 11 of 49 patients (22%) had sequelae recorded during follow-up. None died as a result of HSV-2 CNS disease. Thus, the clinical presentation of HSV-2 infection of the CNS is mainly meningitis but encephalitis does occur and neurological sequelae are common. Recurring lymphocytic meningitis is associated with reactivation of HSV-2 and the condition might be underdiagnosed.
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Affiliation(s)
- Lars Haukali Omland
- From the Department of Infectious Diseases M, Copenhagen University Hospital, Copenhagen, Denmark
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Mori I, Goshima F, Ito H, Koide N, Yoshida T, Yokochi T, Kimura Y, Nishiyama Y. The vomeronasal chemosensory system as a route of neuroinvasion by herpes simplex virus. Virology 2005; 334:51-8. [PMID: 15749122 DOI: 10.1016/j.virol.2005.01.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Revised: 01/04/2005] [Accepted: 01/06/2005] [Indexed: 10/25/2022]
Abstract
We have investigated the potential of neurotropic microbes to invade the central nervous system (CNS) via the peripheral nervous system. Herpes simplex virus type 1 (HSV-1) strain KH6 and herpes simplex virus type 2 (HSV-2) strain 186 were found to infect chemosensory neurons in the vomeronasal organ (the pheromone detector) following intranasal inoculation of mice. HSV-1 strain KH6 infection was further transmitted to the accessory olfactory bulb (first relay), the medial amygdala (second relay), and the bed nucleus of the stria terminalis and the ventromedial hypothalamus (third relay). HSV-1 strain KH6 also targeted the olfactory and trigeminal systems. HSV-2 strain 186 predominantly attacked the brainstem including the trigeminal system. While both viruses did not induce apoptosis in infected chemosensory neurons, they did in infected brain tissue. These results suggest that neurotropic viruses can invade the brain by infecting vomeronasal chemosensory neurons and that the restrained induction of apoptosis in the infected neurons may facilitate viral transmission to the CNS.
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Affiliation(s)
- Isamu Mori
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan.
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Abstract
Viral diseases of the central nervous system encompass a wide range of different processes, mainly inflammation affecting the brain (encephalitis), the meninges (meningitis), or a combined meningoencephalitis. The spinal cord can be affected as well (myelitis). Another group of viral-related disorders, sometimes without a clear pathophysiological mechanism disclosed, include post-viral illnesses. All of these groups of diseases are discussed in this article, with an emphasis on their imaging presentation, using magnetic resonance imaging.
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