Herpes simplex and varicella zoster CNS infections: clinical presentations, treatments and outcomes.
Objectives: To describe the clinical manifestations, cerebrospinal fluid (CSF) characteristics, imaging studies and prognostic factors of adverse clinical outcomes (ACO) among adults with herpes simplex virus (HSV) or varicella zoster virus (VZV) CNS infections. Methods: Retrospective review of adul...
| Publicado en: | Infection Vol. 44; no. 3; pp. 337 - 346 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115832550&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115832550 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Jun2016 vid: 44 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 115832550 115832550 115832550 10.1007/s15010-015-0867-6 115832550 ppf: 337 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Herpes simplex and varicella zoster CNS infections: clinical presentations, treatments and outcomes. aug: au: Kaewpoowat, Quanhathai Salazar, Lucrecia Aguilera, Elizabeth Wootton, Susan Hasbun, Rodrigo affil: Department of Internal Medicine, University of Texas Health Science Center, 6431 Fannin St. 2.112 MSB Houston 77030 USA sug: subj: Herpesvirus Infections Central Nervous System Infections Meningitis, Bacterial Cerebrospinal Fluid Encephalitis Cerebrospinal Fluid Chickenpox Human Polymerase Chain Reaction ab: Objectives: To describe the clinical manifestations, cerebrospinal fluid (CSF) characteristics, imaging studies and prognostic factors of adverse clinical outcomes (ACO) among adults with herpes simplex virus (HSV) or varicella zoster virus (VZV) CNS infections. Methods: Retrospective review of adult patients with positive HSV or VZV polymerase chain reaction on CSF from an observational study of meningitis or encephalitis in Houston, TX (2004-2014), and New Orleans, LA (1999-2008). Results: Ninety-eight adults patients were identified; 25 had encephalitis [20 (20.4 %) HSV, 5 (5.1 %) VZV], and 73 had meningitis [60 (61.1 %) HSV and 13 (13.3 %) VZV]. HSV and VZV had similar presentations except for nausea ( P < 0.01) and rash ( P < 0.001). The CSF profile did not differ between HSV and VZV infection. Abnormal neuroimaging findings were found in 11.6 % (10/86) brain CTs and 21.3 % (16/75) brain MRIs. The EEG was abnormal in 57.9 % (11/19). Sixteen patients (16.3 %) had an ACO (10 HSV encephalitis, 3 VZV encephalitis and 3 VZV meningitis). Intravenous acyclovir administered within 48 h was protective against an ACO [OR 0.19 (0.04-0.80), P = 0.02). However, on logistic regression only Charlson comorbidity score >1 and an encephalitis presentation were independently associated with an ACO. The treatment for HSV meningitis was variable, and all patients had a good clinical outcome. Conclusion: Alpha herpes CNS infections due to HSV and VZV infections have similar clinical and laboratory manifestations. ACO was observed more frequently in those patients with comorbidities and an encephalitis presentation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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