ENCEFALITIS VIRAL PEDIATRIA PDF
Revista Chilena de Pediatría . El diagnóstico oportuno de la encefalitis por virus herpes simple (VHS) 1 y 2 reviste gran importancia, debido a que un. Isolation of influenza virus A/Hong Kong /1/68 (H3N2) from liquor cerebrospinalis of patients with CNS involvement. Med Klin, 70 (), pp. The clinical manifestations and diagnosis of viral encephalitis in children will be discussed here. The pathogenesis, etiology, treatment, and.
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Many neurologic manifestations of Epstein-Barr virus EBV infection have been documented, including encephalitis, aseptic meningitis, transverse myelitis, and Guillain-Barre syndrome.
These encefalltis can occur alone or coincidentally with the clinical picture of infectious mononucleosis. EBV encephalitis is rare and is indicated as a wide range of clinical manifestations. We report a year-old girl presented with fever, gait disturbance, and bizarre behavior for one week.
The results of the physical examination were unremarkable. A cranial MRI demonstrated abnormal high signal intensities in the basal ganglia and the striatal body, especially in the putamen and caudate nucleus. EBV infection should be considered when lesions are localized to the basal ganglia.
EBV can lead to various central nervous system CNS complications include encephalitis, meningitis, cerebellitis, acute disseminated encephalomyelitis ADEMtransverse myelitis, and radiculopathy 1. EBV encephalitis is rare in children but can have severe neurological complications. Encephalitis with EBV pexiatria outcomes that dncefalitis from complete recovery to death. These manifestations can occur alone or in the setting of infectious mononucleosis IM.
Establishing a diagnosis of EBV encephalitis is difficult and consequently molecular, serological, and imaging techniques should be used when investigating children with encephalitis 2. It is evident that Encefalltis infection must be considered in the diagnosis of various acute neurological diseases affecting children, even in the absence of other signs of IM. A pedistria girl was admitted to our hospital with 4-day history of consciousness disturbance and decreased activity.
She had a day history of fever and bizarre behavior such as junk feeding and abusiveness on the 2nd day of illness.
Then, she had decreased activity with a gate disturbance and urine incontinency as well as a suspected history of seizure. On admission, she was lethargic and an examination revealed normal vital signs. There was no lymphadenopathy or hepatosplenomegaly. In the neurological examinations, she was drowsy and unresponsive to verbal commands. Her pupils were normal sized and reactive to light.
Epstein-Barr Virus Encephalitis: A Case Report
Other examinations were unremarkable except for an unsteady gait and neck stiffness. An electroencephalogram EEG showed generalized slow waves. In brain CT scan, we encefalitix nonspecific evidence of brain edema. Encephalitis was confirmed by clinical and radiological findings.
Empirical intravenous antibiotics and Acyclovir were administered, but stopped after the final negative CSF results for microorganisms were obtained. She gradually recovered and discharged after the 14th day of admission. At 6 weeks after the onset encrfalitis illness, she could walk and speak well but could not go back to school.
EBV is a well-known pathogen for infectious mononucleosis IM. Inthe first reports of neurological complications in IM were described 6. EBV infection was demonstrated in 2—9. There are a few reports describing detailed neurological examinations of EBV encephalitis. These MRI changes were similar to Ono et al. Other studies have reported nonspecific findings with MRIs 79.
Normal CT scans from these two reports suggested that the demyelinating process or vasculitis might play an important role in the basal ganglia lesions 6. Since EBV has a tropism for the deep nuclei, neuroimaging can show characteristic multiple foci of T2-weighted or FLAIR hyper intensity in the hemispheric cortex, brain stem, bilateral thalami, and basal ganglia.
Rarely extensive white matter lesions have been reported in patients with chronic EBV infection and clinical relapse of neurologic problems 8. In our patient, brain MRI showed high signal intensities in both basal ganglia. Brain CT scan had nonspecific brain edema. These findings are similar to Kou et al. Disorders that affect both basal ganglia include Leigh syndrome, mitochondrial encephalopathy, Wilson disease, and glutaric aciduria type 2 6.
In our patients, these disorders were excluded by clinical, serologic, and immunologic tests. The prognosis associated with EBV encephalitis is controversial and usually associated with recovery in spite of the severe manifestations that may require assisted ventilation 6.
EBV should be considered in any acute illness of uncertain etiology in the pediatric population EBV infection should be considered when lesions are localized to the basal ganglia 6. In conclusionEBV infection is a common identifiable cause of acute childhood encephalitis and remains the most common agent mimicking herpes simplex virus encephalitis that can be identified with MRI findings of high signal intensities in basal ganglia and documented with serologic tests.
We offer are thanks to the staff at radiology and laboratory department at Ghaem Medical Center. Beiraghy helped in submission and J. Akhondian edited the manuscript. National Center for Biotechnology InformationU.
Iran J Child Neurol.
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Author information Article notes Copyright and License information Disclaimer. Abstract Many neurologic manifestations of Epstein-Barr virus EBV infection have been documented, including encephalitis, aseptic meningitis, transverse myelitis, and Guillain-Barre syndrome.
Encephalitis, Basal ganglia, Epstein-Barr virus. Case report Pefiatria year-old girl was admitted to our hospital ebcefalitis 4-day history of consciousness disturbance and decreased activity. Open in a separate window. Brain MRI Flaire image showing hyperintensities in basal ganglias.
Acknowledgment We offer are thanks to the staff at radiology and laboratory department at Ghaem Medical Center. Hashemian searched related articles, F. Ashrafzadeh wrote the manuscript, M. Mathew AG, Parvez Y. Fulminant Epstein Barr virus encephalitis. Epstein Barr virus encephalitis: Peciatria diversity and radiological similarity.
Baskin HJ, Hedlund G. Neuroimaging of Herpes Virus Infections in Children. Journal of Medical Virology. Epstein-Barr Virus Encephalitis in Children. Support Center Support Center.