Encephalitis herpes simplex virus

Herpes simplex virus encephalitis after myxedema coma has been described in an 81-year-old man treated with hydrocortisone (100 mg 8-hourly) and levothyroxine (328). In renal transplantation, two cases of death from Herpes simplex as a result of glucocorticoid treatment are on record (SED-8, 827 SEDA-17, 449). 

Doherty MJ, Baxter AB, Longstreth WT Jr. Herpes simplex virus encephalitis complicating myxedema coma treated with corticosteroids. Neurology 2001 56(8) 1114-5. 

Vidarabine, an antiviral agent (10 to 15 mg/kg/day for 5 to 10 days), is indicated in the treatment of herpes simplex virus encephalitis, neonatal herpes simplex virus infections, and herpes zoster in immunosuppressed patients. In addition, vidarabine (ophthalmic ointment 3% vidarabine monohydrate [equivalent to 2.8% vidarabine]) is indicated in the treatment of acute keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus types 1 and 2, or superficial keratitis caused by herpes simplex virus that has not responded to topical idoxuridine or when toxic or hypersensitivity reactions to idoxuridine have occurred. 

Observational stndies In a multicenter, open study of a pediatric oral famciclovir formulation in 18 infants aged 1-12 months with a suspicion or evidence of herpes simplex virus infection, 8 had at least 1 adverse event, aU within 8 days, and most after 3 or more days, with the exception of 1 case of fever reported after 31 days [22. Of 17 individual adverse events recorded, the most common were vomiting (n = 3), diarrhea (n=2), pyrexia (n = 2) and dehydration (n=2). The only severe adverse event was in an immimo-compromised infant who had oral candidiasis and developed worsening herpes simplex virus encephalitis, but this was not thought to have been related to famciclovir. 

Rand, K.H. Bodor, N. el Koussi, AA. Raad, I. Miyake, A. Houck, H. Gildersleeve, N. Potential treatment of herpes simplex virus encephalitis by brain-specific delivery of trifluorothymidine using a dihydropyridine in equilibrium pyridinium salt type redox delivery system, J.Med.Virol., 1986, 20, 1-8. 

The genes of the inducible and the constitutively expressed forms of NOS have been cloned and expressed. The expression of inducible NOS in the brain tissue of animals with experimentally induced neurological disorders (boma disease virus and rabies virus in rats), herpes simplex virus (mice) and experimental allergic encephalitis (in rats) suggests that NO produced by induced NOS may be a toxic fector in the pathogenesis of neurological diseases (Koprowski et /., 1993). 

Tyler KL. Herpes simplex virus infections of the central nervous system Encephalitis and meningitis, including Mollaret s. Herpes 2004 ll(suppl2) 57A-64A. 

Despite the protective effect of NO against various viral infections, workers in several studies have shown a harmful role of NO in many systems. NO seems to play a part in the development of pneumonia caused by influenza virus [128], in the pathogenesis in mice of tick-borne encephalitis flavivirus infection [131], and in worsening the course of the murine myocarditis caused by coxsackievirus B3 [132]. In addition, pneumonia in mice induced by herpes simplex virus type 1 could be suppressed by the inhibitor of iNOS [133]. The issue of whether NO acts as an inhibitor of viral replication or as a harmful agent, therefore, remains unanswered. This issue is particularly evident in HIV-1 infection, since NO seems to act as a double-edged sword in the pathogenesis of HIV-1. 

According to the CDC, the diagnosis of AIDS constitutes certain opportunistic infections, neoplasms, encephalopathy or wasting syndrome in the presence of HIV infection. In 1993, the CDC expanded the criteria to also include CD4+ T-cell count below 200 cells/p,l in the presence of HIV infection. The most common opportunistic infections includepneumocystis carinii pneumonia, pneumonitis, toxoplasmosis, mycobacterial disease, recurrent herpes simplex virus infection and/or cytomegalovirus infection. Kaposi s sarcoma is the most common form of cancer. HIV-related nervous system diseases include acute septic meningitis, AIDS dementia complex, subacute encephalitis, HIV encephalopathy and CNS opportunistic infections and neoplasm. 

The antiviral activity of 322, determined351 using primary rabbit kidney cells injected with HS V-l (Herpes Simplex Virus type 1), showed that BVFRU has antiviral potency and transport characteristics suitable for in vivo diagnosis of HSE (Herpes Simplex Encephal-ities) because of greater stability of bromine-carbon bonds than iodine-carbon bond present in [131I]IVDU352, [( )-5-(2-iodovinyl)-l-(2-deoxy- -D-ribofuranosyl)uracil]. 

Vidarabine [vye DARE a been] arabinofuranosyl adenine, ara-A, adenine arabinoside) is one of the most effective of the nucleoside analogs and is also the least toxic. However, it has been supplanted clinically by acyclovir, which is more efficacious and safe. Although vidarabine is active against herpes simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV), its use is limited to treatment of immunocompromised patients with herpes simplex keratitis or encephalitis, or VZV infections. Vidarabine, an adenosine analog, is converted in the cell to its 5 -triphosphate analog (ara-ATP), which is postulated to inhibit viral DNA synthesis. Some resistant herpes virus... 

Aciclovir is prescribed empirically to cover encephalitis (inflammation of the brain parenchyma) caused by the herpes simplex virus (HSV). Confirmed HSV encephalitis is relatively rare (170 laboratory confirmed cases per annum in... 

Herpes Simplex Virus Ophthalmia Neonatorum. HSY infection is an uncommon but important cause of neonatal infection and is associated with conjunctivitis in 5% to 10% of cases.The clinical manifestations are nonspecific and include conjimctival hyperemia, chemosis, periorbital edema, and mucous discharge. Corneal involvement is not uncommon and can include dendritic, geographic, or stromal keratitis. Herpetic ophthalmia neonatorum represents a primary herpetic infection. Central nervous system involvement, encephalitis, retinitis, optic neuritis, uveitis, choroiditis, and a fetal viremia can be serious sequelae of primary herpetic infections. 

Herpes simplex virus type 1 (HSV-1) is a member of the Herpesviridae family. HSV infection is endemic in the population. The primary symptom of infection is recurrent fever blisters. On occasion, infection can lead to more serious symptoms such as encephalitis and retinitis. In particular, immunocompromised patients, such as those undergoing chemotherapy treatments or receiving organ transplants, and acquired immunodeficiency syndrome (AIDS) victims are at particular risk of developing life-threatening complications due to reactivation of latent infections. 

Keywords Encephalitis Herpes simplex virus type 1 Varicella zoster virus Cytomegalovirus West Nile virus Acyclovir Valacyclovir Ganciclovir Cidofovir Famciclovir Foscamet Latencyneurological disorders Fifecycle... 

DeBiasi RL, Kleinschmidt-DeMasters BK, Richardson-Burns S, Tyler KL (2002) Central nervous system apoptosis in human herpes simplex virus and cytomegalovirus encephalitis. J Infect Dis 186 1547-1557. 

Kurt-Jones EA, Chan M, Zhou S, Wang J, Reed G, Bronson R, Arnold MA, Knipe DM, Finberg RW (2004) Herpes simplex virus 1 interaction with toll-like receptor 2 contributes to lethal encephalitis. Proc Natl Acad Sci USA 101 1315-1320. 

Antiviral activity has been demonstrated mainly for A. membranaceus, that represents the most studied species, expecially against Coxsackie viruses [234] but also against different kinds of viral infections. "Astragali radix" extracts show protective effects against Japanese Encephalitis Vitus (JEV) infection in mice both by oral and infraperitoneal injection this effect is based on a non-specific mechanism during the early stage of injection, before it shifts to antibody production. A. membranaceus (AM) shows curative effects on the mice infected with Herpes Simplex Virus type-1 (HSV-1) when somministated with acyclovir (ACV) [329]. The anti-HSV activity of suppository and ointment forms of AM combined... 

Simko JP, Caliendo AM, Hogle K, Versalovic J. Differences in laboratory findings for cerebrospinal fluid specimens obtained from patients with meningitis or encephalitis due to herpes simplex virus (HSV) documented by detection of HSV DNA. 

Nonpolio enteroviruses such as coxsackieviruses A and B, echo viruses, and enteroviruses 70 and 71 cause approximately 85% of all viral encephalitis cases. The remaining 10% to 15% of viral encephalitis cases are caused by a variety of pathogens, such as arboviruses, adenoviruses, influenzae virus A and B, rotavirus, corona virus, cytomegalovirus, varicella-zoster, herpes simplex virus, Epstein-Barr virus, and lymphocytic choriomeningitis. In the past, the St. Louis and LaCrosse viruses have been the most common cause... 

Acyclovir is the drug of choice for herpes simplex encephalitis. In patients with normal renal function, acyclovir is usually administered as 10 mg/kg intravenously every 8 hours for 2 to 3 weeks. Herpes virus resistance to acyclovir has been reported with increasing incidence, particularly from immunocompromised patients with prior or chronic exposures to acyclovir. The alternative treatment for acyclovir-resistant herpes simplex virus is foscarnet. The major toxicity of foscarnet is renal impairment, and doses must be individualized for renal function. The dose for patients with normal renal function is 40 mg/kg infused over 1 hour every 8 to 12 hours for 2 to 3 weeks. Ensuring adequate hydration is imperative. In addition, patients receiving foscarnet should be monitored for seizures related to alterations in plasma electrolyte levels. 

Herpes simplex viruses (HSV) types 1 and 2 cause significant morbidity in patients with AIDS. Seropositivity for HSV is widespread among adults with AIDS, and clinical disease usually is the result of reactivation of latent virus. The manifestations of HSV disease observed in persons with AIDS include orolabial, genital, and anorectal mucocutaneous disease esophagitis and less commonly, encephalitis. Ulcerative HSV lesions present for longer than 1 month in an individual with laboratory evidence for HIV infection or no other apparent cause for immunodeficiency are considered an AIDS-defining condition. 

Schmidbauer M, Budka H, Ambros P. Herpes simplex virus (HSV) DNA in microglial nodular brainstem encephalitis. / NeuropatholExp Neurol. 1989 48 645-652. 

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