Mixt-herpesvirus neuroinfections: peculiarities of clinical picture and diagnistics
DOI:
https://doi.org/10.15587/2313-8416.2015.52196Keywords:
herpesvirus infections, mixt-neuroinfections, liquor, diagnostics, clinical manifestations, immunogram, nervous systemAbstract
In the article it was presented an analysis of etiological structure, clinical and diagnostic peculiarities of mixt-herpesvirus neuroinfections.
Aim of the work: To study clinical and diagnostic peculiarities of mixt-herpesvirus neuroinfections.
Materials and methods: There was carried out a retrospective analysis of examination and therapy of 976 patients who underwent a hospital treatment in intensive care and detoxification department of SI “Institute of epidemiology and infectious diseases of L.V. Gromashevsky, NAMS of Ukraine” during the last 12 years.
Results of research: According to the study of biological mediums (liquor, blood, saliva) monoinfection was diagnosed in 653 (66,9%) patients, mixt-infection – in 323 (33,1 %) patients. Virus-virus infections considerably dominated in the structure of mixt-neuroinfections – 246 (76,2 %). Among virus-virus infections mixt-herpesvirus infection was observed in 192 (78,1 %) patients and most often was presented as combination of HSV+CMV- 57 (29,7 %); HSV+EBV – 45 (23,4 %), EBV+HHV6 – 34 (17,7 %). In patients with mixt-herpesvirus infection (192 cases) it was observed the most diversity of clinical forms: in 8 (4,2 %) patients -meningoencephalitis, in 4 (2,1 %) – leukoencephalitis, in 64 (33,3 %) – menongoencerebritis, in 47 (24,8 %) – disseminated encephalomyelitis, in 43 (22,4 %) – encephalomyelopolyradiculoneuritis, in 26 (13,5 %) – encephalomyelitis. Combined forms of nervous system injuries with demyelinization were registered reliably more often.
Conclusions: Causative agents capable for the long persistence namely herpesviruses (78,1 %) play the main role in development of mixt-virus neuroinfection. Prognosis of disease in these cases depends on timely diagnostics, individual approach to treating tactics and dispensary care. The heavy combined forms of nervous system injuries with demyelinization especially leukoencephalitis and disseminated encephalomyelitis are registered reliably more often in patients with mixt-virus neuroinfection. There were detected reliable differences in neurological manifestations of herpesvirus injury of nervous system in patients with mono- and mixt-infection. The main diagnostic syndromes in this case are psychopathic, cognitive, extra pyramid, epileptiform and neuroendocrine ones
References
Cenzerlyng, V. A., Chuhlovyna, M. L. (2005). Ynfekcyonnye porazhenyja nervnoj systemy. Sankt-Peterburg: Uzd. JeLBY-SPb., 480.
Damulin, I. V. (2004). Infektsionnyie zabolevaniya nervnoy sistemyi. Nevrologicheskiy zhurnal, 5, 54–62.
Liopo, T. V., Vasilev, A. V., Vasilev, V. S. et. al. (2007). Neyroinfektsii v otdelenii intensivnoy terapii. Med. panorama, 12, 3–5.
Sorokina, M. N., Skripchenko, N. V. (2004). Virusnyie entsefalityi i meningityi u detey: Rukovodstvo dlya vrachey. Moscow: OAO «Izdatelstvo «Meditsina», 416.
Bogadelnikov, I., Kushnir, G. (2008). Laboratornyie metodyi diagnostiki pri narushenii funktsii TsNS pri infektsionnyih boleznyah u detey. Zdorove rebenka, 3, 116–121.
Zavalishina, I. A., Spirina, N. N., Boyko, A. N. (Eds.) (2011). Hronicheskie neyroinfektsii. Moscow: GEOTAR- Media, 560.
Frolov, A. F. (1995). Persistentsiya virusov (mehanizmyi i kliniko-epidemiologicheskie aspektyi). Vinnitsa: Izdatelstvo Vinnitskogo meditsinskogo Universiteta im. N. I. Pirogova, 223.
Vozianova, Zh. I. (2000). Infektsionnyie i parazitarnyie bolezni. Vol. 1. Kyiv: Zdorov’ya, 157–198.
Kuznetsov, S. V., Kirsanova, I. O., Manukyan, T. S. (2010). KlInIchnI I laboratorno-InstrumentalnI osoblivostI mIkst-gerpesvIrusnih menIngItIv u dItey. MedItsIna sogodnI I zavtra, 1, 96–99.
Isakov, V. A., Borisova, V. V. et. Al (1999). Gerpes: patogenez i laboratornaya diagnostika: Rukovodstvo dlya vrachey. Sankt-Peterburg: Izdatelstvo «Lan», 192.
Kononenko, V. V., Rudenko, A. O., Chepkiy, L. P. et. al. (2003). Gerpetichniy entsefalIt u doroslih (klInIka, dIagnostika ta Intensivna terapIya): Metod. rekomendatsii. MOZ UkraYini. Kyiv, 40.
Kononenko, V. V., Yarosh, O. O., Barshteyn, Yu. A. et. al (2003). TsitomegalovIrusniy entsefalIt u doroslih Imunokompetentnih hvorih (klInIka, dIagnostika ta Intensivna terapIya): MetodichnI rekomendatsii. Kyiv, 27.
Zou, W. Y., Guo, Q. L., Yang, Y. et. al (2008). Analgesic effect of intrathecal injection of Herpes simplex virus type I amplicon vector-mediated human preproenkephalin gene on chronic neuropathic pain: experiment with rats. Zhonghua Yi Xue Za Zhi, 88 (29), 2064–2068.
Thurner, B., Spangenberg, P., Kleines, M., Blaum, M., Scheithauer, S. (2007). Continuous Intrathecal Interferon Alpha Application in Subacute Sclerosing Panencephalitis. The Pediatric Infectious Disease Journal, 26 (9), 863. doi: 10.1097/inf.0b013e31812e01e8
Phares, T. W., Marques, C. P., Stohlman, S. A., Hinton, D. R., Bergmann, C. C. (2010). Factors Supporting Intrathecal Humoral Responses following Viral Encephalomyelitis. Journal of Virology, 85 (6), 2589–2598. doi: 10.1128/jvi.02260-10
Ihekwaba, U. K., Kudesia, G., McKendrick, M. W. (2008). Clinical Features of Viral Meningitis in Adults: Significant Differences in Cerebrospinal Fluid Findings among Herpes Simplex Virus, Varicella Zoster Virus, and Enterovirus Infections. Clinical Infectious Diseases, 47 (6), 783–789. doi: 10.1086/591129
Downloads
Published
Issue
Section
License
Copyright (c) 2015 Олена Леонідівна Панасюк
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
