ENCEPHALITIS. Selected Viral causes of acute encephalitis/myelitis Herpesvirus: Herpes simplex virus, Varicella–zoster virus, Herpes B virus, Epstein–Barr.

Slides:

Advertisements

Similar presentations

Microbiology Nuts & Bolts Test Yourself Session 4 Begin here.

Advertisements

Case Study 20 Craig Horbinski, M.D., Ph.D.. The patient was a full-term, 4-week-old baby who presented with failure to thrive, lethargy, hypotonia, poor.

Testing algorithms used at Bureau of Labs Michigan Department of Community Health Information on testing algorithms for processing and reporting serological.

Viral Encephalitis John Nuara, Salwa Touma, Kelly Wines Microbiology and the Control of Infectious Diseases April 22, 2003.

OVERVIEW  acute onset and fluctuating symptoms  disturbance of consciousness (including inattention)  at least one of the following:  Disorganised.

HSV Encephalitis Jack Kuritzky, PGY-2 UNC Internal Medicine August 31, 2009.

Carol Kirrane Lecturer Practitioner

Encephalitis Brain Abscess Reşat Özaras, MD, Prof. Infection Dept.

VIRAL ENCEPHALITIS A range of viruses can cause encephalitis but only a minority of patients have a history of recent viral infection. In Europe, the most.

ENCEPHALITIS Presented by : 51: Abdulaziz Al-Qahtani

Primarily by Linda Wallen, MD Edited May, 2005

Infections of Central Nervous System. Section one: Survey Ⅰ. concept : all kinds of pathogens of organisms intrude into cerebral parenchyma, cerebral.

Herpes Simplex Virus Encephalitis Benedict Daniel Michael Benedict Michael (NIHR Doctoral Research Registrar in Neurology ) works at the Institute of Infection.

Herpes Dr. Meg-angela Christi Amores. Herpes Simplex Etiologic agent: – Herpes Simplex Virus (HSV) DNA virus HSV 1 and HSV 2.

Chapter 14: Animal Viruses

Subacute/Chronic meningitis Reşat ÖZARAS, MD, Prof. Infection Dept.

In the name of god.

Aseptic meningitis  definition: When the CSF culture was negative.  CSF: pressure mmh2o: normal or slightly elevated. leukocytes : PMN early mononuclear.

Genital Herpes.

Infections of the Central Nervous System Zheng dongming.

Viral Encephalitis.

MENINGITIS Prof Mohammad Abduljabbar Prof Mohammad Abduljabbar.

TUBERCULOUS MENINGITIS Dr Shreedhar Paudel April, 2009.

Laboratory exams in the diagnosis of CNS infections Dr Paul Matthew Pasco June 7, 2008.

Primary Care Conference May 25, 2005 Becky Byers MD Guest patient Charlie Byers PhD.

Myopathy, Neuropathy, CNS Infections Rachel Garvin, MD Assistant Professor, Neurocritical Care Department of Neurosurgery.

Toll-Like Receptors in CNS Viral Infections Unclear role of TLRs in natural infections TLR3, -7, -8, -9 recognize viral nucleic acids. Localized intracellularly.

1 Copyright © 2014 Elsevier Inc. All rights reserved. Chapter 43 Nervous System Complications of Systemic Viral Infections John E. Greenlee.

Central Nervous System Infections. RABIES.

Common viral infections HERPES VIRUS INFECTIONS The objectives of this lecture:  To know the clinically important HVs.  To know the common characteristics.

HERPES SIMPLEX ENCEPHALITIS ENCEPHALITIS M.RASOOLINEJAD, MD DEPARTMENT OF INFECTIOUS DISEASE TEHRAN UNIVERCITY OF MEDICAL SCIENCE.

Viral Meningitis Myra Lalas Pitt. Definition  Meningeal inflammation with negative cultures for routine bacterial pathogens in a patient who did not.

Morning Report August 9, 2010.

VIRAL ENCEPHALITIS.

Quize of the week Hajer AlZuhair Medical resident.

Prions “small proteinaceous infectious agents without a nucleic acid genome……produce spongiform encephalopathies”

Viruses “an intracellular, infectious parasite capable of living and replicating only in living cells”

Prof. Dalia M. Mohsen Prof. In Microbiology. Viral the level of order and follows as thus, with the taxon suffixes classification starts at given in italics:

MEASLES (RUBEOLA) VIRUS Genus Morbillivirus. PARAMYXOVIRIDAE Paramyxovirinae Genus respirovirus: Genus Rubulavirus Genus morbillivirus Pneumovirinae Genus.

Mike Parenteau. Etiology / Pathophysiology Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. Sometimes, encephalitis.

CNS INFECTIONS.

ASNR 2015 Isolated Cerebellar Leptomeningeal Involvement

2011 Diagnostic Slide Session Case 7 Aditya Raghunathan Suzanne Z. Powell.

Myocarditis and pericarditis Dr Ali M Somily Prof Hanan A Habib.

CNS INFECTION. Definitions:Definitions: Meningitis : infection predominantly involved subarachniod space.Meningitis : infection predominantly involved.

Encephalopathy. Encephalitis an inflammation of the brain parenchyma and presents as an alteration in consciousness, fever, headache, seizures, and/or.

Herpes Simplex Virus Karen Estrella-Ramadan 07/02/12.

Meningitis. Learning objectives Gain organised knowledge in the subject area of meningitis Be able to correctly interpret clinical findings in patients.

CNS INFECTION Dr. Basu MD. CNS INFECTION Meningeal Infection: meningitis Brain parenchymal infection { encephalitis}

A 12 years old boy with behavioral disorders F.Ahmadabadi Child neurologist.

Approach to the Patient with Altered Mental Status…and Fever.

DR.S. MANSORI INFECTIOUS DISEASE SPECIALIST QAZVIN UNIVERCITY OF MEDICAL SCIENCE.

 Direct  Indirect  Direct: -Microscopy -Culture -Antigen -Nucleic acid  Indirect: -Specific antibody (Serology)

Fahareen-Binta-Mosharraf MNS. Disease-causing viruses often grouped by their route of transmission Enteric viruses Generally transmitted via fecal-oral.

Intracranial infection. Objectives To know about clinical presentation of meningitis and Encephalitis To know about the common infective organisms responsible.

Imaging of Epilepsy Ali Jassim Alhashli Year IV – Unit VIII (CNS) – Problem 6.

MENINGITIS الحمى الشوكية – التهاب السحايا

Ramez Morkous MS4 Medical University Of the Americas April 29, 2016

Prognosis and Therapy of Viral Encephalitis in Adults

Relationship between CMV & PU disease

Third year medical students Faculty of medicine, Mutah University

Acute Meningitis BY MBBSPPT.COM

Prof. Mohammad Abduljabbar

Use of the polymerase chain reaction in the diagnosis of herpes simplex encephalitis: a decision analysis model∗ Pablo Tebas, MD, Robert F Nease, PhD,

Encephalitis Atman Shah.

CLINICAL PROBLEM SOLVING

European guidelines for diagnosis and management of patients with suspected herpes simplex encephalitis Miles Denton, Kevin G Kerr, Fraser Lewis Clinical.

Is an inflammation of cerebral tissue typically accompanied by meningeal inflammation, caused by an infection or other source.

Viruses and Encephalitis

Presentation transcript:

ENCEPHALITIS

Selected Viral causes of acute encephalitis/myelitis Herpesvirus: Herpes simplex virus, Varicella–zoster virus, Herpes B virus, Epstein–Barr virus, Cytomegalovirus Flaviviridae: West Nile, Japanese, Dengue Poliovirus Rabies Meales, mumps Influenza (postinfectious?) HIV

Selected non-Viral causes of acute encephalitis/myelitis Rickettsia, Brucella, Mycoplasma, Bartonella, Lyme dis., syphilis Toxoplasma, Plasmodium falciparum Endocarditis Vasculitis Carcinoma Drug reaction (chemotherapy: methotrexate)

Herpes simplex Encephalitis The most commonly identified cause of acute, sporadic viral encephalitis; 10 to 20% of all cases Subtype 1 virus causes more than 95% of cases of HSV encephalitis In children and young adults, primary HSV infection may result in encephalitis; virus enters the central nervous system (CNS) by neurotropic spread from the periphery via the olfactory bulb

Herpes simplex Encephalitis In about 25% of the patients, the HSV-1 strains from the oropharynx and brain tissue of the same patient differ; thus some cases may result from reinfection with another strain of HSV-1 that reaches the CNS Most adults with HSV encephalitis have clinical or serologic evidence of mucocutaneous HSV-1 infection before the onset of the CNS symptoms. HSV DNA has been demonstrated in brain tissue from healthy adults. ( = reactivation)

Herpes simplex Encephalitis בת 51, בריאה בדר " כ, מזה 3 ימים חום 37.8 וכאב ראש שהלכו והתגברו. היום הובאה לחדר המיון עקב מאורע של התכווצויות. כשהתעוררה הייתה מבולבלת ולא התמצאה במקום ובזמן. בבדיקה נמדד חום 39.6, נצפתה דיספזיה ( קושי בדיבור ) וחולשה בפלד הגוף הימני.

Herpes simplex Encephalitis: Diagnosis CSF WBC: cells/mm 3 (rare;y < 5) Protein: 30-2,500, median 80 (normal<60) Glucose usually normal EEG: spike and slow wave activity from the temporal lobe. Sensitivity 85%. Specificity 33%.

Herpes simplex Encephalitis (HSE): Diagnosis CT: Edema in the temporal lobe hemorrhagic necrosis midline shift Low density lesions of the temporal lobe: 44/50 (88%) in HSE and in 8/71 (11%) in non-HSE. 16/44 (36%) HSE patients had lesions in the frontal lobe. 1/44 occipital, 1/44 parietal. First 5 days: CT sensitivity 73%, specificity 89% >5 days: CT sensitivity 90%, specificity 92%

HSE: MRI is more sensitive, especially for identifying edema. The neuroimaging technique of choice!!!

Herpes simplex Encephalitis: confirmation of etiology Brain biopsy (complications 3%) Serologic analysis in serum and CSF: low sensitivity in the first 10 days. CSF Cultures: negative PCR in CSF: highly sensitive and specific. The diagnostic procedure of choice.

Detection of intrathecal anti-HSV antibodies

PCR of HSV DNA from CSF samples

HSE: acute, focal, necrotizing encephalitis with cerebral edema and petechial hemorrhages

Herpes simplex Encephalitis : Treatment IV acyclovir (10 mg/kg x 3/day over 1 hour) is effective in reducing the rates of death (70% 24%) and morbidity Early therapy is a critical factor in outcome!!! In suspected cases: start acyclovir empirically If PCR negative and no other support for HSE, stop acyclovir Long-term cognitive abnormalities