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Santos MB, Rodrigues Gonçalves AC, Maltez F. Cytomegalovirus and Herpes Simplex Virus Co-Infection: Recurrence in a Kidney Transplant Recipient. ACTA MEDICA PORT 2023; 36:751-752. [PMID: 36848643 DOI: 10.20344/amp.19227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/06/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Maria Beatriz Santos
- Serviço de Medicina Interna. Hospital de Santo Espírito da Ilha Terceira. Angra do Heroísmo. Portugal
| | | | - Fernando Maltez
- Serviço de Doenças Infeciosas. Hospital Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal
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2
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Bani-Sadr A, Ruitton-Allinieu MC, Brisset JC, Ducray F, Joubert B, Picard G, Cotton F. Contribution of diffusion-weighted imaging to distinguish herpetic encephalitis from auto-immune encephalitis at an early stage. J Neuroradiol 2022; 50:288-292. [PMID: 35662572 DOI: 10.1016/j.neurad.2022.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To determine whether diffusion-weighted imaging (DWI) can help to distinguish early stage autoimmune (AI) and herpes simplex virus (HSV) encephalitides. METHODS This case-control study included patients from a multi-center cohort of AI encephalitides whose initial MRI including DWI was performed within ten days after symptoms onset. They were compared with patients with HSV encephalitis enrolled prospectively in a single-center from June, 2020 to December, 2020. The final diagnosis of AI encephalitis required a positive autoantibody assay, and that of HSV encephalitis required a positive HSV polymerase chain reaction based on cerebrospinal fluid. Brain MRI were evaluated for restricted diffusion, fluid-inversion recovery (FLAIR) abnormalities, lesion topography, hemorrhagic changes, and contrast enhancement. RESULTS Forty-nine patients were included of which, 19 (38.8%) had AI encephalitis. Twenty-seven patients (55.1%) were males and the median age was 46.0 years (interquartile range (IQR):[22.0; 65.0]). Brain MRI were performed after a median of 4 days (IQR:[2.0; 7.0]) of symptom onset and time between symptom onset and MRI was not significantly different (p=0.60). Twenty-six patients had restricted diffusion lesions in the medial temporal lobe, including 25/30 in the HSV encephalitis group (p<0.001). FLAIR abnormalities were observed in 36 patients, including 29/30 in the HSV encephalitis group (p<0.001). Lesion topography, hemorrhagic changes, and contrast enhancement did not differ significantly between the two groups. CONCLUSION Our results suggest that restricted diffusion lesions in the medial temporal lobe are a hallmark of HSV encephalitis and may help distinguish it from early-stage AI encephalitis.
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Affiliation(s)
- Alexandre Bani-Sadr
- Service de Radiologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France; Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Marie-Camille Ruitton-Allinieu
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69495, Pierre-Bénite, France
| | | | - François Ducray
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - Bastien Joubert
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - Géraldine Picard
- Centre National de Référence pour les Syndromes Neurologiques Paranéoplasiques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - François Cotton
- Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France; Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69495, Pierre-Bénite, France.
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3
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Pedrazini MC, da Silva MH, Groppo FC. L-lysine in herpesvirus reactivation after ChAdOx1 nCoV-19 vaccine (AZD1222): minor literature review and case report. Dermatol Ther 2021; 35:e15291. [PMID: 34962036 DOI: 10.1111/dth.15291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/13/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Cristina Pedrazini
- Professor - Department of Dental Sciences - São Leopoldo Mandic Research Center., Brazil.,Doctoral Student - Department of Biosciences - Piracicaba Dental School - FOP - UNICAMP - Campinas - São Paulo State, Brazil
| | - Mariliza Henrique da Silva
- Infectologist - Department of Infectology Diagnosis - IST/AIDS State Program, ITD/AIDS Reference and Training Center - São Paulo São Paulo State, Brazil
| | - Francisco Carlos Groppo
- Full Professor - Department of Biosciences - Piracicaba Dental School - FOP - UNICAMP - Campinas - São Paulo State, Brazil
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4
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Tavakolian S, Goudarzi H, Eslami G, Darazam IA, Dehghan G, Faghihloo E. Detection of Enterovirus, Herpes Simplex, Varicella Zoster, Epstein-Barr and Cytomegalovirus in cerebrospinal fluid in meningitis patients in Iran. J Clin Lab Anal 2021; 35:e23836. [PMID: 34152040 PMCID: PMC8275001 DOI: 10.1002/jcla.23836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
Background Despite medical advances, central nervous system (CNS) diseases put a pressure on the health care system. A number of risk factors, especially infectious agents can accelerate the progression of meningitis. As viruses probably account for most cases of meningitis, the diagnosis of them can reduce antibiotic prescriptions. Among various types of infectious diseases, the relationship between two important virus families, including Picornaviridae and Herpesviridae, and meningitis has attracted attraction. Methods In this study, one hundred and two samples were collected from patients who experienced symptoms, such as the loss of consciousness, seizures, muscle weakness, fever, headache, rash, and severe dementia, between November 2018 and September 2019. After RNA and DNA extraction, the prevalence of Enterovirus (EV), Cytomegalovirus (CMV), Epstein–Barr virus (EBV), Herpes simplex virus type 1 (HSV‐1), Herpes simplex virus type 2 (HSV‐2), and Varicella zoster virus (VZV) was evaluated using PCR, multiplex PCR, and nested PCR. Results Results indicated that there were two VZV DNA‐positive specimens, while six and five samples were infected with HSV‐1 and EBV, respectively. Conclusion We reported that the prevalence of EBV, HSV‐1, and VZV in patients, suffering from meningitis cannot be ignored; however, further investigation is needed.
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Affiliation(s)
- Shaian Tavakolian
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ilad Alavi Darazam
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golnaz Dehghan
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ebrahim Faghihloo
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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5
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Harfouche M, Maalmi H, Abu-Raddad LJ. Epidemiology of herpes simplex virus type 2 in Latin America and the Caribbean: systematic review, meta-analyses and metaregressions. Sex Transm Infect 2021; 97:490-500. [PMID: 34088792 PMCID: PMC8543241 DOI: 10.1136/sextrans-2021-054972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/14/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To characterise epidemiology of herpes simplex virus type 2 (HSV-2) in Latin America and the Caribbean. Methods HSV-2 reports were systematically reviewed and synthesised, and findings were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analyses and metaregressions were conducted. Finding 102 relevant reports were identified including 13 overall incidence measures, 163 overall (and 402 stratified) seroprevalence measures, and 7 and 10 proportions of virus detection in genital ulcer disease and in genital herpes, respectively. Pooled mean seroprevalence was 20.6% (95% CI 18.7% to 22.5%) in general populations, 33.3% (95% CI 26.0% to 41.0%) in intermediate-risk populations, 74.8% (95% CI 70.6% to 78.8%) in female sex workers, and 54.6% (95% CI 47.4% to 61.7%) in male sex workers, men who have sex with men and transgender people. In general populations, seroprevalence increased from 9.6% (95% CI 7.1% to 12.4%) in those aged <20 years to 17.9% (95% CI 13.6% to 22.5%) in those aged 20–30, 27.6% (95% CI 21.4% to 34.2%) in those aged 30–40 and 38.4% (95% CI 32.8% to 44.2%) in those aged >40. Compared with women, men had lower seroprevalence with an adjusted risk ratio (ARR) of 0.68 (95% CI 0.60 to 0.76). Seroprevalence declined by 2% per year over the last three decades (ARR of 0.98, 95% CI 0.97 to 0.99). Pooled mean proportions of HSV-2 detection in GUD and genital herpes were 41.4% (95% CI 18.9% to 67.0%) and 91.1% (95% CI 82.7% to 97.2%), respectively. Conclusions One in five adults is HSV-2 infected, a higher level than other world regions, but seroprevalence is declining. Despite this decline, HSV-2 persists as the aetiological cause of nearly half of GUD cases and almost all of genital herpes cases.
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Affiliation(s)
- Manale Harfouche
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar.,WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Haifa Maalmi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar .,WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
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Lima RB, Borges MDAP, Araújo LFD, Martins CJ. Herpetic whitlow in a child with AIDS: the importance of Tzanck test in the diagnosis. An Bras Dermatol 2021; 96:477-481. [PMID: 34016479 PMCID: PMC8245730 DOI: 10.1016/j.abd.2020.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 11/17/2022] Open
Abstract
Herpetic whitlow is a viral infection of the fingers caused by the herpes simplex virus. The disease has a bimodal age distribution, affecting children under 10 years of age and young adults between 20 and 30 years old. It can be easily mistaken for panaritium or bacterial cellulitis. In patients with AIDS, atypical, chronic and recurrent ulcerated lesions occur. The Tzanck test allows a quick and low-cost diagnosis of herpes simplex virus infection. The authors report the case of a child with AIDS with painful finger ulcers in which the diagnosis was confirmed by the Tzanck test.
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Affiliation(s)
| | | | | | - Carlos José Martins
- Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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7
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Bowers EMR, Esianor BI, Kimura K, Lewis JS, Topf MC. Disseminated Herpes Simplex Infection Presenting as Acute Supraglottitis in an Adult. Head Neck Pathol 2020; 15:1074-1081. [PMID: 33372241 PMCID: PMC8385039 DOI: 10.1007/s12105-020-01255-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
Supraglottitis is a life-threatening, predominantly bacterial disease that is rarely caused by viral etiologies. Herpes Simplex Virus (HSV) supraglottitis has been infrequently reported, but its presentation can mimic that of bacterial supraglottitis or pharyngitis which may lead to delayed diagnosis and increased morbidity. We present a case of supraglottitis in an immunocompetent man initially thought to have bacterial epiglottitis. After receiving a tracheostomy due to impending airway compromise and failing to improve on antibiotic therapy, biopsy of the upper airway tissue revealed infection with HSV type 2. The patient improved after multiple weeks of systemic antivirals. HSV supraglottitis remains an unusual but important diagnostic consideration in patients with dysphonia, dysphagia, ulcerative supraglottal lesions, and acute supraglottic inflammation unresponsive to antibiotics.
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Affiliation(s)
| | - Brandon I. Esianor
- Vanderbilt University Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S. Suite 7209, Nashville, TN 37232 USA
| | - Kyle Kimura
- Vanderbilt University Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S. Suite 7209, Nashville, TN 37232 USA
| | - James S. Lewis
- Vanderbilt University Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S. Suite 7209, Nashville, TN 37232 USA ,Vanderbilt University Department of Pathology, Microbiology, and Immunology, Nashville, USA
| | - Michael C. Topf
- Vanderbilt University Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S. Suite 7209, Nashville, TN 37232 USA
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8
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Barroso Dos Reis HL, Tosato Boldrini NA, da Silva Campos LC, Campos LG, Salume Costa FL, Jacomele Caldas JV, Pedras Almeida SL, Miranda AE. Hypertrophic genital herpes in an HIV-infected female patient: Imiquimod as an alternative treatment. Int J Infect Dis 2020; 95:153-156. [PMID: 32311452 DOI: 10.1016/j.ijid.2020.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 11/16/2022] Open
Abstract
Herpes Simplex Virus (HSV) is the leading cause of genital ulcers worldwide. In Human Immunodeficiency Virus (HIV) co-infected individuals, rare hypertrophic pseudo-tumoral forms have been described as simulating squamous cell carcinoma or other viral infections such as those caused by Varicella zoster, Molluscum contagiosum and HPV induced lesions. Here, we report a case of hypertrophic genital herpes in an HIV-infected patient effectively treated with surgery and topical 5% imiquimod after the recurrence of lesions. A 45-year-old woman, HIV-positive for 17 years and on regular antiretroviral therapy, presented with a painful 2cm vulvar sessile lesion, a 1cm ulcerated lesion on the clitoral hood, and a slightly elevated lesion in the middle third of the tongue. Excisional biopsy and surgical removal of lesion were performed for histopathological exam. Histopathology of genital lesions showed evidence of chronic lymphoplasmacytic inflammation, intense ulcerated plasmacytosis, and squamous cells displaying HSV cytopathogenic effect. After three months, the patient presented with a new ulcerated perineal lesion. Histopathology showed evidence of chronic ulcerative-vegetative herpetic dermatitis. Consequently, topical 5% imiquimod was administered with successful results. Relapsing character and atypical genital disease evolution with an exophytic pseudotumoral injury have been noted in patients co-infected with HIV and HSV, necessitating anatomopathological recognition for diagnostic confirmation and exclusion of malignancy. Local immunotherapy should be considered as treatment approach.
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Affiliation(s)
- Helena Lucia Barroso Dos Reis
- Infectious Diseases Post-Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
| | | | - Luisa Cardoso da Silva Campos
- Infectious Diseases Post-Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
| | - Letícia Goulart Campos
- Pathology Residency Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
| | - Franco Luis Salume Costa
- Gynecology and Obstetrics Residency Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
| | - João Victor Jacomele Caldas
- Gynecology and Obstetrics Residency Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
| | | | - Angelica Espinosa Miranda
- Infectious Diseases Post-Graduate Program, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
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9
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Drayman N, Patel P, Vistain L, Tay S. HSV-1 single-cell analysis reveals the activation of anti-viral and developmental programs in distinct sub-populations. eLife 2019; 8:e46339. [PMID: 31090537 PMCID: PMC6570482 DOI: 10.7554/elife.46339] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/11/2019] [Indexed: 12/12/2022] Open
Abstract
Viral infection is usually studied at the population level by averaging over millions of cells. However, infection at the single-cell level is highly heterogeneous, with most infected cells giving rise to no or few viral progeny while some cells produce thousands. Analysis of Herpes Simplex virus 1 (HSV-1) infection by population-averaged measurements has taught us a lot about the course of viral infection, but has also produced contradictory results, such as the concurrent activation and inhibition of type I interferon signaling during infection. Here, we combine live-cell imaging and single-cell RNA sequencing to characterize viral and host transcriptional heterogeneity during HSV-1 infection of primary human cells. We find extreme variability in the level of viral gene expression among individually infected cells and show that these cells cluster into transcriptionally distinct sub-populations. We find that anti-viral signaling is initiated in a rare group of abortively infected cells, while highly infected cells undergo cellular reprogramming to an embryonic-like transcriptional state. This reprogramming involves the recruitment of β-catenin to the host nucleus and viral replication compartments, and is required for late viral gene expression and progeny production. These findings uncover the transcriptional differences in cells with variable infection outcomes and shed new light on the manipulation of host pathways by HSV-1.
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Affiliation(s)
- Nir Drayman
- Institute for Molecular EngineeringThe University of ChicagoChicagoUnited States
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoUnited States
| | - Parthiv Patel
- Institute for Molecular EngineeringThe University of ChicagoChicagoUnited States
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoUnited States
| | - Luke Vistain
- Institute for Molecular EngineeringThe University of ChicagoChicagoUnited States
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoUnited States
| | - Savaş Tay
- Institute for Molecular EngineeringThe University of ChicagoChicagoUnited States
- Institute for Genomics and Systems BiologyThe University of ChicagoChicagoUnited States
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10
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Abstract
Herpes Simplex Virus infections (HSV) are ubiquitous. The neonatal HSV infection (NHSV) is rare. The incidence is estimated globally at only 10.3 per 100,000 births, but it can cause devastating disease in premature infants. Both HSV-1 and HSV-2 can be the etiologic agents in this type of vertically transmittted NHSV infection. Here we describe the pathological findings from a complete autopsy of a very low birth weight infant who succumbed to the infection despite early institution of antiviral treatment. We urge more awareness of this disease with continued surveillance; every effort should be taken to make an early diagnosis and thus prevent this devastating disease.
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Affiliation(s)
- Ranjit I Kylat
- University of Arizona, College of Medicine, Department of Pediatrics. Tucson, AZ, USA
| | - Joel Addams
- University of Arizona, College of Medicine, Department of Pathology. Tucson, AZ, USA
| | - Richard E Sobonya
- University of Arizona, College of Medicine, Department of Pathology. Tucson, AZ, USA
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11
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Moshirfar M, Hopping GC, Vaidyanathan U, Liu H, Somani AN, Ronquillo YC, Hoopes PC. Biological Staining and Culturing in Infectious Keratitis: Controversy in Clinical Utility. Med Hypothesis Discov Innov Ophthalmol 2019; 8:145-151. [PMID: 31598516 PMCID: PMC6778464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Infectious keratitis causes significant, financial burden and is only increasing in frequency with contact lens use. Despite this, no retrospective studies, prospective studies, or clinical trials have evaluated the diagnostic validity of clinical guidelines in cases of infectious keratitis. Currently, standard of care recommends that corneal samples be obtained for staining and culturing in select patients showing evidence of corneal ulceration. Ideally, diagnostic information from corneal sampling is thought to help guide therapeutic interventions, prevent disease progression, reduce antibiotic resistance, and decrease overall expenditures for the management and treatment of infectious keratitis. However, current staining and culturing methods are limited by poor sensitivity in non-bacterial cases (i.e. fungal, viral) and lengthy turnaround times, and these methods do not frequently change clinical decision making. Newer fluoroquinolones and broad-spectrum antibiotics resolve the vast majority of cases of infectious keratitis, rendering cultures less essential for management. We studied the clinical utility of obtaining corneal samples for culturing and staining and the need for future research to establish superior diagnostic guidelines for their use in infectious keratitis.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
- Utah Lions Eye Bank, Murray, UT, USA
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Grant C. Hopping
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Uma Vaidyanathan
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Harry Liu
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Anisha N. Somani
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | | | - Phillip C. Hoopes
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
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12
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Croll BJ, Dillon ZM, Weaver KR, Greenberg MR. MRI diagnosis of herpes simplex encephalitis in an elderly man with nonspecific symptoms. Radiol Case Rep 2016; 12:159-160. [PMID: 28228902 PMCID: PMC5310538 DOI: 10.1016/j.radcr.2016.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/10/2016] [Accepted: 11/23/2016] [Indexed: 11/24/2022] Open
Abstract
A 78-year-old male presented to the Emergency Department complaining of a 1-week onset of increasing fatigue and anorexia. The patient was previously well but had a history of depression, chronic diarrhea, and hypertension. His examination was remarkable for mild fever (100.1°F). He had no acute neurologic deficits. The patient felt better after intravenous fluids and was discharged to follow-up with the primary care provider. With no resolution of symptoms and new memory loss, the patient's primary care doctor ordered an MRI which revealed abnormal signal/patchy enhancement of the left temporal lobe indicative (pathognomonic) of herpes simplex encephalitis. This case emphasizes the importance of early consideration of herpes simplex encephalitis in the differential of patient's with these symptoms.
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Affiliation(s)
- Benjamin J Croll
- Department of Emergency Medicine, Lehigh Valley Hospital /USF Morsani College of Medicine, CC & I-78, Allentown, PA 18103, USA
| | - Zachary M Dillon
- Department of Emergency Medicine, Lehigh Valley Hospital /USF Morsani College of Medicine, CC & I-78, Allentown, PA 18103, USA
| | - Kevin R Weaver
- Department of Emergency Medicine, Lehigh Valley Hospital /USF Morsani College of Medicine, CC & I-78, Allentown, PA 18103, USA
| | - Marna Rayl Greenberg
- Department of Emergency Medicine, Lehigh Valley Hospital /USF Morsani College of Medicine, CC & I-78, Allentown, PA 18103, USA
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13
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Abstract
Erythema Multiforme, (EM) is an uncommon, acute inflammatory disease of the skin and mucous membranes characterized by ulcerations caused by hypersensitivity to drugs, microbial agents or other allergens. An EM outbreak can result in more severe forms of EM involving the skin, and there are several types of EM manifestations. A hemorrhagic crust on the lip is a pathognomonic sign of this disease. Target lesions may or may not be present in EM cases. When target lesions are not present on the skin, it is very difficult to make a differential diagnosis of EM. Herpes associated erythema multiforme (HAEM) is an uncommon lesion caused by herpes simplex virus infection. A case of severe painful lesions in a 28-year-old pregnant patient with HAEM is presented here. HAEM is rarely found in pregnant women, and its clinical findings, diagnosis and treatment have not previously been reported.
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Affiliation(s)
- Kobkan Thongprasom
- Oral Medicine Department, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand
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14
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Yun SJ, Jeong P, Kang HW, Kim YH, Kim EA, Yan C, Choi YK, Kim D, Kim JM, Kim SK, Kim SY, Kim ST, Kim WT, Lee OJ, Koh GY, Moon SK, Kim IY, Kim J, Choi YH, Kim WJ. Urinary MicroRNAs of Prostate Cancer: Virus-Encoded hsv1-miRH18 and hsv2-miR-H9-5p Could Be Valuable Diagnostic Markers. Int Neurourol J 2015; 19:74-84. [PMID: 26126436 DOI: 10.5213/inj.2015.19.2.74] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 06/13/2015] [Indexed: 11/08/2022] Open
Abstract
PURPOSE MicroRNAs (miRNAs) in biological fluids are potential biomarkers for the diagnosis and assessment of urological diseases such as benign prostatic hyperplasia (BPH) and prostate cancer (PCa). The aim of the study was to identify and validate urinary cell-free miRNAs that can segregate patients with PCa from those with BPH. METHODS In total, 1,052 urine, 150 serum, and 150 prostate tissue samples from patients with PCa or BPH were used in the study. A urine-based miRNA microarray analysis suggested the presence of differentially expressed urinary miRNAs in patients with PCa, and these were further validated in three independent PCa cohorts, using a quantitative reverse transcriptionpolymerase chain reaction analysis. RESULTS The expression levels of hsa-miR-615-3p, hsv1-miR-H18, hsv2-miR-H9-5p, and hsa-miR-4316 were significantly higher in urine samples of patients with PCa than in those of BPH controls. In particular, herpes simplex virus (hsv)-derived hsv1-miR-H18 and hsv2-miR-H9-5p showed better diagnostic performance than did the serum prostate-specific antigen (PSA) test for patients in the PSA gray zone. Furthermore, a combination of urinary hsv2-miR-H9-5p with serum PSA showed high sensitivity and specificity, providing a potential clinical benefit by reducing unnecessary biopsies. CONCLUSIONS Our findings showed that hsv-encoded hsv1-miR-H18 and hsv2-miR-H9-5p are significantly associated with PCa and can facilitate early diagnosis of PCa for patients within the serum PSA gray zone.
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Amel Jamehdar S, Mammouri G, Sharifi Hoseini MR, Nomani H, Afzalaghaee M, Boskabadi H, Aelami MH. Herpes simplex virus infection in neonates and young infants with sepsis. Iran Red Crescent Med J 2014; 16:e14310. [PMID: 24719742 PMCID: PMC3965875 DOI: 10.5812/ircmj.14310] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/04/2013] [Accepted: 11/24/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Neonatal herpes infection is the most serious complication of Herpes Simplex Virus (HSV) infection during pregnancy and perinatal period. Few studies have reported neonatal HSV infection in developing countries. OBJECTIVES The aim of this study was to detect the HSV infection among neonates and infants with sepsis. MATERIALS AND METHODS In a cross sectional study all infants aged less than 3 months, admitted to neonatal intensive care unit and pediatric emergency ward of Ghaem Hospital (a university hospital with 900 beds) in Mashhad (Northeast of Iran) with clinical diagnosis of sepsis and at least one inclusion criteria during one year from November 2009 to October 2010, were enrolled in the study. Polymerase chain reaction (PCR) was done on clinical samples obtained from patients. RESULTS Among 150 neonates and infants younger than 3 months old with sepsis, the PCR results for detecting the HSV DNA, were positive in 6 samples of 5 patients (3.3 %). None of the mothers had symptomatic HSV infection during delivery. The mean age of the patients was 18 days. Two of them died due to shock and disseminated intravascular coagulation (DIC). CONCLUSIONS In neonates and infants with primary diagnosis of sepsis, HSV infection should be considered especially if the clinical condition does not improve after 48 hours of antibiotic therapy, and sepsis still exists with elevated liver enzymes.
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Affiliation(s)
- Saeid Amel Jamehdar
- Department of Microbiology and Virology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Gholamali Mammouri
- Department of Pediatrics, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Mohammad Reza Sharifi Hoseini
- Department of Pediatrics, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Hosein Nomani
- Department of Microbiology and Virology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Monavvar Afzalaghaee
- Department of Biostatistics, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Hassan Boskabadi
- Department of Pediatrics, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Mohammad Hassan Aelami
- Department of Pediatrics and Infection Control & Hand Hygiene Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding Author: Mohammad Hassan Aelami, Department of Pediatrics and Infection Control & Hand Hygiene Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-9153595747, Fax: +98-5118593045, E-mail:
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