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Cytomegalovirus Encephalitis in HIV

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Educational Case: Opportunistic Infections of the Central Nervous System.

Steven Toffel, Lymaries Velez, Jorge Trejo-Lopez, Stacy G Beal, Jesse L Kresak,

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and ... Read more >>

Acad Pathol (Academic pathology)
[2020, 7:2374289520901809]

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Presence of Epstein-Barr virus DNA in cerebrospinal fluid is associated with greater HIV RNA and inflammation.

Tommaso Lupia, Maria Grazia Milia, Cristiana Atzori, Sara Gianella, Sabrina Audagnotto, Daniele Imperiale, Lorenzo Mighetto, Veronica Pirriatore, Gabriella Gregori, Filippo Lipani, Valeria Ghisetti, Stefano Bonora, Giovanni Di Perri, Andrea Calcagno,

OBJECTIVE:The current study aimed to investigate whether cerebrospinal fluid (CSF) Epstein-Barr virus (EBV) or cytomegalovirus (CMV) DNA was associated with viral, inflammatory and neuronal damage biomarkers in people living with HIV (PLWH). DESIGN:A cross-sectional diagnostic study on CSF fluid samples in patients undergoing lumbar punctures for clinical reasons, to better ... Read more >>

AIDS (AIDS (London, England))
[2020, 34(3):373-380]

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Adaptive and Innate Immune Cells in Fetal Human Cytomegalovirus-Infected Brains.

Yann Sellier, Florence Marliot, Bettina Bessières, Julien Stirnemann, Ferechte Encha-Razavi, Tiffany Guilleminot, Nacilla Haicheur, Franck Pages, Yves Ville, Marianne Leruez-Ville,

BACKGROUND:The understanding of the pathogenesis of cytomegalovirus (CMV)-induced fetal brain lesions is limited. We aimed to quantify adaptive and innate immune cells and CMV-infected cells in fetal brains with various degrees of brain damage. METHODS:In total, 26 archived embedded fetal brains were studied, of which 21 were CMV-infected and classified ... Read more >>

Microorganisms (Microorganisms)
[2020, 8(2):]

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Editorial: Cytokine-Mediated Organ Dysfunction and Tissue Damage Induced by Viruses.

Juliet V Spencer, Piotr Religa, Michael H Lehmann,

Front Immunol (Frontiers in immunology)
[2020, 11:2]

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A 9-month retrospective evaluation of the aetiology and management of patients presenting with encephalitis/meningoencephalitis at a South London hospital.

Tehmina Bharucha, Lina Nashef, Nick Moran, Sue Watkins, David Brown, Mark Zuckerman,

Encephalitis causes high morbidity and mortality. An incidence of 4.3 cases of encephalitis/100 000 population has been reported in the UK. We performed a retrospective evaluation of the diagnosis and management of adults admitted to hospital with a clinical diagnosis of encephalitis/meningoencephalitis. Clinical, laboratory and radiological data were collated from ... Read more >>

Epidemiol. Infect. (Epidemiology and infection)
[2020, 148:e23]

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Viscerotropic disease and acute uveitis following yellow fever vaccination: a case report.

Lev Volkov, Gilda Grard, Pierre-Edouard Bollaert, Guillaume A Durand, Aurélie Cravoisy, Marie Conrad, Lionel Nace, Guilhem Courte, Rémy Marnai, Isabelle Leparc-Goffart, Sébastien Gibot,

BACKGROUND:Yellow fever vaccine exists for over 80 years and is considered to be relatively safe. However, in rare cases it can produce serious neurotropic and viscerotropic complications. We report a case of a patient who presented both viscerotropic and neurological manifestations after yellow fever vaccination. CASE PRESENTATION:We describe the case of ... Read more >>

BMC Infect. Dis. (BMC infectious diseases)
[2020, 20(1):116]

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Beneficial and Detrimental Effects of Regulatory T Cells in Neurotropic Virus Infections.

Malgorzata Ciurkiewicz, Vanessa Herder, Andreas Beineke,

Neurotropic viruses infect the central nervous system (CNS) and cause acute or chronic neurologic disabilities. Regulatory T cells (Treg) play a critical role for immune homeostasis, but may inhibit pathogen-specific immunity in infectious disorders. The present review summarizes the current knowledge about Treg in human CNS infections and their animal ... Read more >>

Int J Mol Sci (International journal of molecular sciences)
[2020, 21(5):]

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Case report: meningitis as a presenting feature of anti-NMDA receptor encephalitis.

Maria Stavrou, Jing Ming Yeo, Alexander David Slater, Oliver Koch, Sarosh Irani, Peter Foley,

BACKGROUND:Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to ... Read more >>

BMC Infect. Dis. (BMC infectious diseases)
[2020, 20(1):21]

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Patient characteristics, clinical manifestations, prognosis, and factors associated with gastrointestinal cytomegalovirus infection in immunocompetent patients.

Thanaboon Chaemsupaphan, Julajak Limsrivilai, Chenchira Thongdee, Asawin Sudcharoen, Ananya Pongpaibul, Nonthalee Pausawasdi, Phunchai Charatcharoenwitthaya,

BACKGROUND:Gastrointestinal (GI) cytomegaloviral (CMV) infection is common among patients with immunocompromised status; however, data specific to GI-CMV infection in immunocompetent patients are comparatively limited. METHODS:This retrospective study included patients diagnosed with GI-CMV infection at Siriraj Hospital (Bangkok, Thailand) during 2008-2017. Baseline characteristics, presentations, comorbid conditions, endoscopic findings, treatments, and outcomes ... Read more >>

BMC Gastroenterol (BMC gastroenterology)
[2020, 20(1):22]

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Evaluating a pilot process for reviewing late HIV diagnoses in England and Wales.

Ming Jie Lee, Hilary Curtis, Clare van Halsema, David R Chadwick,

Late HIV diagnosis is associated with significant mortality in people living with HIV (PLWH) and high numbers of missed opportunities (MO) for earlier testing have been identified. A pilot of a national late diagnosis review process (LDRP) was undertaken in 15 HIV services evaluating the feasibility of LDRP implementation, as ... Read more >>

Clin Med (Lond) (Clinical medicine (London, England))
[2020, 20(2):189-195]

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Management of HIV-infected patients in the intensive care unit.

François Barbier, Mervin Mer, Piotr Szychowiak, Robert F Miller, Éric Mariotte, Lionel Galicier, Lila Bouadma, Pierre Tattevin, Élie Azoulay,

The widespread use of combination antiretroviral therapies (cART) has converted the prognosis of HIV infection from a rapidly progressive and ultimately fatal disease to a chronic condition with limited impact on life expectancy. Yet, HIV-infected patients remain at high risk for critical illness due to the occurrence of severe opportunistic ... Read more >>

Intensive Care Med (Intensive care medicine)
[2020, 46(2):329-342]

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Polymerase chain reaction for the diagnosis of herpesvirus infections in dermatology : Analysis of clinical data.

Verena Schremser, Lukasz Antoniewicz, Erwin Tschachler, Alexandra Geusau,

BACKGROUND:Rapid identification of human herpesviruses from lesion swabs is necessary for timely initiation of antiviral treatment, especially with infections involving neonates and immunocompromised individuals. The aim of the study was to investigate the results of an in-house polymerase chain reaction (PCR) test for herpesviruses in patients with symptoms suggestive for ... Read more >>

Wien. Klin. Wochenschr. (Wiener klinische Wochenschrift)
[2020, 132(1-2):35-41]

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Clinical Course of Opportunistic Infections-Toxoplasmosis and Cytomegalovirus Infection in HIV-Infected Patients in Slovakia.

Katarína Šimeková, Elena Nováková, Róbert Rosoľanka, Jana Masná, Daniela Antolová,

: The HIV/acquired immunodeficiency syndrome (AIDS) pandemic has affected the health status of the population in many countries. Early symptomatic HIV infection includes persistent generalized lymphadenopathy (PGL), which can be associated with opportunistic infections, e.g., toxoplasmosis and Cytomegalovirus (CMV) infection. This study followed the occurrence of PGL, toxoplasmosis, and Cytomegalovirus ... Read more >>

Pathogens (Pathogens (Basel, Switzerland))
[2019, 8(4):]

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Sequential optical coherence tomography images of early acute retinal necrosis.

Aarti Jain, Giridhar Anantharaman, Mahesh Gopalakrishnan, Sandhya Narayanan,

Indian J Ophthalmol (Indian journal of ophthalmology)
[2020, 68(3):520-522]

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Diagnosis of severe respiratory infections in immunocompromised patients.

Elie Azoulay, Lene Russell, Andry Van de Louw, Victoria Metaxa, Philippe Bauer, Pedro Povoa, José Garnacho Montero, Ignacio Martin Loeches, Sangeeta Mehta, Kathryn Puxty, Peter Schellongowski, Jordi Rello, Djamel Mokart, Virginie Lemiale, Adrien Mirouse, ,

An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to ... Read more >>

Intensive Care Med (Intensive care medicine)
[2020, 46(2):298-314]

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Estimating the Risk of Human Herpesvirus 6 and Cytomegalovirus Transmission to Ugandan Infants from Viral Shedding in Saliva by Household Contacts.

Bryan T Mayer, Elizabeth M Krantz, Anna Wald, Lawrence Corey, Corey Casper, Soren Gantt, Joshua T Schiffer,

Human herpesvirus 6 (HHV-6) and cytomegalovirus (CMV) infections are common in early childhood. In a prospective Ugandan birth cohort study, most infants acquired HHV-6 (24/31; 77%) and CMV (20/30; 67%) during follow-up. To assess the transmission risk, we modeled a dose-response relationship between infant HHV-6 and CMV infections and weekly ... Read more >>

Viruses (Viruses)
[2020, 12(2):]

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Branch Retinal Artery Occlusion as a presenting sign of Acute Retinal Necrosis: a rare association.

Manisha Agarwal, Chanda Gupta, Abhishek Jain, Brajesh Kumar,

BACKGROUND:Acute retinal necrosis (ARN) is a potentially blinding necrotizing viral retinitis. It starts with one or more foci and spreads circumferentially and involves the posterior pole in the later stages. Vascular occlusions such as branch retinal artery occlusion, central retinal artery occlusion, and central retinal vein occlusion may occur secondary ... Read more >>

J Ophthalmic Inflamm Infect (Journal of ophthalmic inflammation and infection)
[2020, 10(1):8]

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Detectable HIV-1 in semen in individuals with very low blood viral loads.

Samuel Mundia Kariuki, Philippe Selhorst, Jennifer Norman, Karen Cohen, Kevin Rebe, Carolyn Williamson, Jeffrey R Dorfman,

BACKGROUND:Several reports indicate that a portion (5-10%) of men living with HIV-1 intermittently shed HIV-1 RNA into seminal plasma while on long term effective antiretroviral therapy (ART). This is highly suggestive of an HIV-1 reservoir in the male genital tract. However, the status of this reservoir in men living with HIV-1 who are not ... Read more >>

Virol. J. (Virology journal)
[2020, 17(1):29]

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Efficacy of Tocilizumab in Limbic Encephalitis with Anti-CASPR2 Antibodies.

Maurizio Benucci, Luciana Tramacere, Maria Infantino, Mariangela Manfredi, Valentina Grossi, Arianna Damiani, Francesca Li Gobbi, Maristella Piccininni, Gaetano Zaccara, Massimo Cincotta,

We report the case of a 64-year-old man who presented with subacute memory, balance impairment, behavioral and mood changes, and epileptic seizures. Magnetic resonance imaging (MRI) showed bilateral hippocampal abnormalities. Brain [18F]-FDG fluorodeoxyglucose positron emission tomography (PET) revealed hypometabolism in both the temporal lobe as well as in the left ... Read more >>

Case Rep Neurol Med (Case reports in neurological medicine)
[2020, 2020:5697670]

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Diagnostic Difficulties in a Severely Ill HIV Patient with Multiple Superinfections - A Case Report.

Cristina Mănășturean, Cristiana Oprea, Dan Oțelea, Anca Meda Georgescu,

Introduction:As chronic HIV infection is prone to co-infections more than any other infectious condition, many severely immune-depressed patients require advanced diagnostic investigations and complex treatment. Case report:The case of a 30-year-old severely immune-depressed patient with AIDS, who developed neurological impairment and was diagnosed with encephalitis is presented. Multiple diagnostic approaches ... Read more >>

J Crit Care Med (Targu Mures) (Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures))
[2019, 5(4):136-139]

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A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis.

Christopher B Toomey, Andrew Gross, Jeffrey Lee, Doran B Spencer,

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in ... Read more >>

Case Rep Ophthalmol Med (Case reports in ophthalmological medicine)
[2019, 2019:1475628]

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Neurotuberculosis: Control of Steroid-Refractory Paradoxical Inflammatory Reaction With Ruxolitinib.

Yingda L Xie, Fanny Ita-Nagy, Ray Y Chen, Maura M Manion, Irini Sereti, Luxin Pei, Steven M Holland,

Paradoxical inflammatory reactions associated with treatment of neurotuberculosis can lead to severe morbidity and mortality and may not be controlled by steroids alone. We report the use of the Janus kinase inhibitor ruxolitinib to treat a steroid-refractory neurotuberculosis paradoxical reaction. ... Read more >>

Open Forum Infect Dis (Open forum infectious diseases)
[2019, 6(10):ofz422]

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Infection in the process of organ donation.

O Len Abad,

The difference between demand and supply has led transplant organizations to look for marginal donors, including those who could transmit infections to their recipients. This potential risk must be thoroughly evaluated to optimize the use of such organs without increasing the incidence of graft dysfunction and the morbidity and mortality ... Read more >>

Rev Esp Quimioter (Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia)
[2019, 32 Suppl 2:69-72]

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Causes of fever in Gabonese children: a cross-sectional hospital-based study.

José Francisco Fernandes, Jana Held, Magdalena Dorn, Albert Lalremruata, Frieder Schaumburg, Abraham Alabi, Maradona Daouda Agbanrin, Cosme Kokou, Abel Ben Adande, Meral Esen, Daniel Eibach, Ayola Akim Adegnika, Sélidji Todagbé Agnandji, Bertrand Lell, Isabella Eckerle, Beate Henrichfreise, Benedikt Hogan, Jürgen May, Peter Gottfried Kremsner, Martin Peter Grobusch, Benjamin Mordmüller,

The causes of infections in pediatric populations differ between age groups and settings, particularly in the tropics. Such differences in epidemiology may lead to misdiagnosis and ineffective empirical treatment. Here, we investigated the current spectrum of pathogens causing febrile diseases leading to pediatric hospitalization in Lambaréné, Gabon. From August 2015 ... Read more >>

Sci Rep (Scientific reports)
[2020, 10(1):2080]

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Amyotrophic Lateral Sclerosis-like Syndrome after Chikungunya.

Felipe César Andrade, Vinicius Vergetti, Gabriella Cozza, Maria Clara Falcao, Gustavo Azevedo,

Amyotrophic lateral sclerosis (ALS)-like syndrome refers to a group of conditions whose outcome is similar to that of amyotrophic lateral sclerosis, but with different characteristics in the initial phase and response to therapy. The involvement of an earlier age group, the subacute course, and the stabilization or improvement of the ... Read more >>

Cureus (Cureus)
[2019, 11(10):e5876]

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