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Viral Meningitis HELP
Based on 928 articles published since 2010

These are the 928 published articles about Meningitis, Viral that originated from Worldwide during 2010-2020.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Editorial [Virus in the brain]. 2015

Brandt, Christian. ·Lunge- og Infektionsmedicinsk Afdeling, Nordsjællands Hospital, Hillerød, Dyrehavevej 29, 3400 Hillerød. dr.cbrandt@gmail.com. ·Ugeskr Laeger · Pubmed #25749114.

ABSTRACT: -- No abstract --

2 Editorial Resident good? Persistent infection increases the number of potentially protective T cells localized in peripheral tissue. 2015

Bullock, Timothy. ·Department of Pathology, University of Virginia, Charlottesville, Virginia, USA TB5V@hscmail.mcc.virginia.edu. ·J Leukoc Biol · Pubmed #25649788.

ABSTRACT: -- No abstract --

3 Editorial Editorial: Not all roads to T cell memory go through STAT4 and T-bet. 2014

Whitmire, Jason K. ·University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA jwhitmir@email.unc.edu. ·J Leukoc Biol · Pubmed #27929377.

ABSTRACT: -- No abstract --

4 Editorial Notes from the field: a cluster of lymphocytic choriomeningitis virus infections transmitted through organ transplantation-Iowa, 2013. 2014

Schafer, Ilana J / Miller, Rachel / Ströher, Ute / Knust, Barbara / Nichol, Stuart T / Rollin, Pierre E. · ·Am J Transplant · Pubmed #24854024.

ABSTRACT: -- No abstract --

5 Editorial Economic burden of West Nile virus in the United States. 2014

Barrett, Alan D T. · ·Am J Trop Med Hyg · Pubmed #24515938.

ABSTRACT: -- No abstract --

6 Review Outcomes beyond hospital discharge in infants and children with viral meningitis: A systematic review. 2020

Hudson, Jessica A / Broad, Jonathan / Martin, Natalie G / Sadarangani, Manish / Galal, Ushma / Kelly, Dominic F / Pollard, Andrew J / Kadambari, Seilesh. ·Department of Public Health, John Radcliffe Hospital, Oxford, UK. · Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK. · Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand. · Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada. ·Rev Med Virol · Pubmed #31524309.

ABSTRACT: Viruses are the commonest cause of childhood meningitis, but outcomes beyond hospital discharge are poorly described. We undertook a systematic literature review of long-term outcomes following paediatric viral meningitis. A search was carried out using MEDLINE, Embase, and Cochrane Review for studies from 1 January 1990 to 31 December 2018. Studies were included where specific outcome measures were available beyond hospital discharge for children <16 years old with viral meningitis. In total, 3588 papers were identified of which 14 were eligible for inclusion. Four studies reported outcomes in children with nonenterovirus 71 meningitis. A US study of 16 cases demonstrated subtle language difficulties at 3-year follow-up in infants in contrast to an Australian study, which revealed no impairment in language. A Fijian study showed that two out of eight cases had sensorineural hearing loss compared with none in a UK cohort of 668 infants. Three studies evaluated outcomes of enterovirus 71 meningitis in China and Taiwan, two showed cases recovered without sequelae, while one demonstrated an increased risk of attention deficit hyperactivity disorder. Two studies including 141 cases of human parechovirus revealed no evidence of neurodevelopmental sequelae. Conversely, an Australian study demonstrated neurodevelopmental sequelae in 11 out of 77 infants with parechovirus meningitis. Most studies identified in this review demonstrated a high proportion of good clinical outcomes following viral meningitis. However, the data are limited, so robustly conducted neurodevelopmental studies are warranted to inform the evidence-based management of viral meningitis beyond hospital discharge.

7 Review Complexities of Type I Interferon Biology: Lessons from LCMV. 2019

Suprunenko, Tamara / Hofer, Markus J. ·School of Life and Environmental Sciences, the Marie Bashir Institute for Infectious Diseases and Biosecurity, Charles Perkins Centre, and the Bosch Institute, The University of Sydney, Sydney, NSW 2006, Australia. tsup5163@uni.sydney.edu.au. · School of Life and Environmental Sciences, the Marie Bashir Institute for Infectious Diseases and Biosecurity, Charles Perkins Centre, and the Bosch Institute, The University of Sydney, Sydney, NSW 2006, Australia. markus.hofer@sydney.edu.au. ·Viruses · Pubmed #30791575.

ABSTRACT: Over the past decades, infection of mice with lymphocytic choriomeningitis virus (LCMV) has provided an invaluable insight into our understanding of immune responses to viruses. In particular, this model has clarified the central roles that type I interferons play in initiating and regulating host responses. The use of different strains of LCMV and routes of infection has allowed us to understand how type I interferons are critical in controlling virus replication and fostering effective antiviral immunity, but also how they promote virus persistence and functional exhaustion of the immune response. Accordingly, these discoveries have formed the foundation for the development of novel treatments for acute and chronic viral infections and even extend into the management of malignant tumors. Here we review the fundamental insights into type I interferon biology gained using LCMV as a model and how the diversity of LCMV strains, dose, and route of administration have been used to dissect the molecular mechanisms underpinning acute versus persistent infection. We also identify gaps in the knowledge regarding LCMV regulation of antiviral immunity. Due to its unique properties, LCMV will continue to remain a vital part of the immunologists' toolbox.

8 Review Viruses Teaching Immunology: Role of LCMV Model and Human Viral Infections in Immunological Discoveries. 2019

Abdel-Hakeem, Mohamed S. ·Penn Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. mohaab@pennmedicine.upenn.edu. · Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Kasr El-Aini, Cairo 11562, Egypt. mohaab@pennmedicine.upenn.edu. ·Viruses · Pubmed #30691215.

ABSTRACT: Virology has played an essential role in deciphering many immunological phenomena, thus shaping our current understanding of the immune system. Animal models of viral infection and human viral infections were both important tools for immunological discoveries. This review discusses two immunological breakthroughs originally identified with the help of the lymphocytic choriomeningitis virus (LCMV) model; immunological restriction by major histocompatibility complex and immunotherapy using checkpoint blockade. In addition, we discuss related discoveries such as development of tetramers, viral escape mutation, and the phenomenon of T-cell exhaustion.

9 Review High-throughput sequencing for the aetiologic identification of viral encephalitis, meningoencephalitis, and meningitis. A narrative review and clinical appraisal. 2019

Zanella, M-C / Lenggenhager, L / Schrenzel, J / Cordey, S / Kaiser, L. ·Laboratory of Virology, Division of Laboratory Medicine and Division of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland; University of Geneva Medical School, Geneva, Switzerland. Electronic address: marie-celine.zanella@hcuge.ch. · Laboratory of Virology, Division of Laboratory Medicine and Division of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland; University of Geneva Medical School, Geneva, Switzerland. · University of Geneva Medical School, Geneva, Switzerland; Laboratory of Bacteriology, Division of Laboratory Medicine and Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. ·Clin Microbiol Infect · Pubmed #30641229.

ABSTRACT: BACKGROUND: Viral aetiologies are the most common cause of central nervous system (CNS) infections. Approximately one-half of CNS infections remain of undetermined origin. High-throughput sequencing (HTS) brought new perspectives to CNS infection investigations, allowing investigation of viral aetiologies with an unbiased approach. HTS use is still limited to specific clinical situations. OBJECTIVES: The aim of this review was to evaluate the contribution and pitfalls of HTS for the aetiologic identification of viral encephalitis, meningoencephalitis, and meningitis in CNS patient samples. SOURCES: PubMed was searched from 1 January 2008 to 2 August 2018 to retrieve available studies on the topic. Additional publications were included from a review of full-text sources. CONTENT: Among 366 studies retrieved, 29 used HTS as a diagnostic technique. HTS was performed in cerebrospinal fluid and brain biopsy samples of 307 patients, including immunocompromised, immunocompetent paediatric, and adult cases. HTS was performed retrospectively in 18 studies and prospectively in 11. HTS led to the identification of a potential causal virus in 41 patients, with 11 viruses known and ten not expected to cause CNS infections. Various HTS protocols were used. IMPLICATIONS: The additional value of HTS is difficult to quantify because of various biases. Nevertheless, HTS led to the identification of a viral cause in 13% of encephalitis, meningoencephalitis, and meningitis cases in which various assays failed to identify the cause. HTS should be considered early in clinical management as a complement to routine assays. Standardized strategies and systematic studies are needed for the integration of HTS in clinical management.

10 Review Pediatric West Nile Virus-Associated Neuroinvasive Disease: A Review of the Literature. 2019

Herring, Rachelle / Desai, Nilesh / Parnes, Mered / Jarjour, Imad. ·Section of Child Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. Electronic address: rmariej@gmail.com. · Section of Neuroradiology, Department of Radiology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. · Section of Child Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. ·Pediatr Neurol · Pubmed #30611518.

ABSTRACT: Over the past two decades, West Nile virus has become the most common arbovirus in North America, leading to several outbreaks and infecting thousands of people. Mosquitos help transmit the virus in the majority of cases, but transmission occurs via blood transfusions, organ transplantation, and possibly pregnancy and breastfeeding. While most infected patients experience mild to no symptoms, thousands of West Nile virus-associated neuroinvasive cases have been reported in the United States, with over 700 cases occurring in children from 2003 to 2016. Neuroinvasive disease presents as meningitis, encephalitis, or acute flaccid paralysis, and carries a high likelihood of poor outcome, including severe neurological disability or death. To date, no pharmacologic treatment has proven effective. Therapeutic clinical trials have not been successfully completed due to the sporadic nature of viral outbreaks and resultant poor study enrollment. Although older age and chronic disease are risk factors for neuroinvasive West Nile virus disease in adults, the specific factors that influence the risk in pediatric populations have not been fully elucidated. This review summarizes the most recent literature regarding West Nile virus-associated neuroinvasive disease, especially as it pertains to the pediatric population. Moreover, the review describes the epidemiology, clinical, laboratory, and radiographic findings, and outlines the various therapies that have been trialed and potential future research directions.

11 Review Enterovirus and parechovirus infections in children: differences in clinical presentation, mechanisms for meningitis without pleocytosis and mechanisms involved in the neurological outcome. 2019

de Crom, Stephanie C. ·Department of Pediatrics, Bravis Hospital, Roosendaal, The Netherlands - stephanie_de_crom@hotmail.com. ·Minerva Pediatr · Pubmed #30511561.

ABSTRACT: Enterovirus (EV) and Parechovirus (HPeV) are a frequent cause of infection in children. This review gives an overview of possible causes for differences in clinical presentation. EV and HPeV can cause a meningitis with or without pleocytosis. Different possible mechanisms for meningitis without pleocytosis are given. Little is known about the prognosis and long-term effects of EV and HPeV meningitis in children. Only some studies with a small number of children with EV or HPeV meningitis are reported. The different possible mechanisms involved in the neurological outcome after EV or HPeV meningitis will be discussed.

12 Review Strategies to improve detection and management of human parechovirus infection in young infants. 2019

Kadambari, Seilesh / Harvala, Heli / Simmonds, Peter / Pollard, Andrew J / Sadarangani, Manish. ·Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK. Electronic address: seilesh.kadambari@paediatrics.ox.ac.uk. · Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, UK; Department of Infection and Immunity, University College of London, London, UK. · Nuffield Department of Medicine, University of Oxford, Oxford, UK. · Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK. · Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK; Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada. ·Lancet Infect Dis · Pubmed #30322791.

ABSTRACT: Human parechovirus infections are the second most common cause of viral meningitis in children. These infections are most frequently seen in infants younger than 90 days. Clinical manifestations include encephalitis, meningitis, myocarditis, and sepsis, which can lead to serious neurodevelopmental sequelae in young infants. Molecular techniques, including PCR assays, are the preferred diagnostic methods and have contributed to an increase in reported cases, along with an increasing awareness of the causal role of human parechovirus in infant diseases. However, focused clinical and diagnostic investigations of human parechovirus in infants and the use of their results in management is varied, partly because of the scarcity of robust incidence data and spectrum of clinical presentations of the infection. In this Review, we outline clinical cohort and epidemiological studies that can be used to inform the evidence-based management of young infants with human parechovirus disease and identify key research priorities. An improved understanding of the pathogenesis and epidemiology of these infections is required to inform an evidence-based approach to diagnosis and treatment in the future.

13 Review Usefulness of blood and cerebrospinal fluid laboratory testing to predict bacterial meningitis in the emergency department. 2019

Julián-Jiménez, A / Morales-Casado, M I. ·Servicio de Urgencias, Complejo Hospitalario de Toledo, Toledo, España. Electronic address: agustinj@sescam.jccm.es. · Servicio de Neurología, Complejo Hospitalario de Toledo, Toledo, España. ·Neurologia · Pubmed #27469578.

ABSTRACT: INTRODUCTION: The classic clinical presentation of bacterial meningitis (BM) is observed in less than half of the cases in adults, and symptoms are less specific in children, the elderly or immunocompromised, and other chronic patients. The usual signs and symptoms do not provide optimal sensitivity and specificity for distinguishing possible BM from viral meningitis (VM), which may lead to a delay in the appropriate antimicrobial therapy. Society therefore stands to benefit from the development of effective, objective, and rapid tools able to predict and identify patients with BM. These tools include laboratory tests for blood and cerebrospinal fluid (CSF). The aim of this review is to summarise recently published scientific evidence in order to clarify existing controversies and compare the usefulness and diagnostic ability of the different parameters used to predict BM. DEVELOPMENT: Systematic search of the main bibliographic databases and platforms to identify articles published between January 2000 and January 2016. We selected 59 articles that meet the objectives of this review. CONCLUSIONS: CSF lactate, proportion of polymorphonuclear leukocytes, and CSF glucose, as well as serum procalcitonin (PCT), are the independent factors most predictive of bacterial aetiology. The model that combines serum PCT and CSF lactate achieves the highest predictive power for BM, with a sensitivity and specificity exceeding 99%. We should consider BM when CSF lactate >33 md/dL and/or PCT>0.25ng/mL.

14 Review PI3K Orchestrates T Follicular Helper Cell Differentiation in a Context Dependent Manner: Implications for Autoimmunity. 2018

Preite, Silvia / Huang, Bonnie / Cannons, Jennifer L / McGavern, Dorian B / Schwartzberg, Pamela L. ·National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, United States. · National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States. · National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States. ·Front Immunol · Pubmed #30666254.

ABSTRACT: T follicular helper (Tfh) cells are a specialized population of CD4

15 Review Lymphocytic choriomeningitis virus meningoencephalitis in a renal transplant recipient following exposure to mice. 2018

Tanveer, Farah / Younas, Mariam / Fishbain, Joel. ·Division of Infectious Disease, St. John Hospital and Medical Center, Grosse Pointe Woods, Michigan. ·Transpl Infect Dis · Pubmed #30325104.

ABSTRACT: Solid organ transplant recipients (SOTR) are at increased risk for a wide variety of typical and atypical infections as a consequence of impaired cell mediated and humoral immunity. We report a case of meningoencephalitis in a renal transplant recipient caused by lymphocytic choriomeningitis virus (LCMV) acquired by exposure to mice excreta. The clinical course was complicated by the development of hydrocephalus, requiring a ventriculoperitoneal shunt. To our knowledge, this is the first reported case of LCMV infection in a SOTR that was not organ donor derived.

16 Review Viral Meningitis and Encephalitis. 2018

Lyons, Jennifer L. · ·Continuum (Minneap Minn) · Pubmed #30273240.

ABSTRACT: PURPOSE OF REVIEW: This article discusses meningitis and encephalitis infections caused by viruses, excluding herpes family and human immunodeficiency virus (HIV). RECENT FINDINGS: The viral infections of the nervous system detailed in this article have no specific treatment other than supportive care. However, many of the viruses discussed are highly preventable by vaccination, proper skin protection against transmitting vectors, and postexposure prophylaxis. SUMMARY: While meningitis and encephalitis caused by viruses may have some clinical overlap, the management and outcomes can be highly disparate, making distinction between the two imperative. Furthermore, despite their relative rarity in terms of clinical disease, many of the viral infections discussed herein are highly preventable. Given the morbidity and mortality attached to such infections, provider and patient education are the best approach available to prevent these potentially devastating illnesses.

17 Review The Role of Procalcitonin in the Diagnosis of Meningitis: A Literature Review. 2018

Velissaris, Dimitrios / Pintea, Martina / Pantzaris, Nikolaos / Spatha, Eirini / Karamouzos, Vassilios / Pierrakos, Charalampos / Karanikolas, Menelaos. ·Department of Medicine, University of Patras, 26504 Patras, Greece. dimitrisvelissaris@yahoo.com. · University of Medicine and Pharmacy, 400337 Cluj-Napoca, România. martina.pintea@yahoo.com. · School of Medicine University of Patras, 26500 Patras, Greece. npantzaris@gmail.com. · School of Medicine University of Patras, 26500 Patras, Greece. eirini.spatha@outlook.com. · Intensive Care Unit, University Hospital of Patras, Rion 26500, Greece. karamouzos@hotmail.com. · Intensive Care Department, Brugmann University Hospital, 1020 Brussels, Belgium. charalampos.pierrakos@chu-brugmann.be. · Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63144, USA. menelaos.karanikolas@wustl.edu. ·J Clin Med · Pubmed #29891780.

ABSTRACT: OBJECTIVE: To review the current published literature on the use of procalcitonin as a diagnostic and prognostic marker in adult patients with meningitis. METHODS: We conducted a PubMed search to identify all relevant publications regarding the diagnostic and prognostic value of serum procalcitonin in patients with a known or suspected central nervous system infection. We also reviewed the bibliographies of all identified manuscripts in an attempt to identify additional relevant references. RESULTS: A significant body of evidence suggests that serum procalcitonin has a promising role and can be a useful biomarker in the assessment of patients with meningitis. CONCLUSIONS: Our literature review suggests that data on the role of Cerebrospinal Fluid (CSF) procalcitonin are limited, whereas serum procalcitonin (S⁻PCT) is probably a useful tool in the evaluation of patients with a known or suspected central nervous system infection and can help distinguish between bacterial and viral meningitis.

18 Review CD8 T Cell Exhaustion in Chronic Infection and Cancer: Opportunities for Interventions. 2018

Hashimoto, Masao / Kamphorst, Alice O / Im, Se Jin / Kissick, Haydn T / Pillai, Rathi N / Ramalingam, Suresh S / Araki, Koichi / Ahmed, Rafi. ·Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia 30322, USA; email: mhashi4@emory.edu , akamphorst@emory.edu , sejin.im@emory.edu , karaki@emory.edu , rahmed@emory.edu. · Department of Urology, Emory University School of Medicine, Atlanta, Georgia 30322, USA; email: haydn.kissick@emory.edu. · Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia 30322, USA; email: rnpilla@emory.edu , ssramal@emory.edu. ·Annu Rev Med · Pubmed #29414259.

ABSTRACT: Antigen-specific CD8 T cells are central to the control of chronic infections and cancer, but persistent antigen stimulation results in T cell exhaustion. Exhausted CD8 T cells have decreased effector function and proliferative capacity, partly caused by overexpression of inhibitory receptors such as programmed cell death (PD)-1. Blockade of the PD-1 pathway has opened a new therapeutic avenue for reinvigorating T cell responses, with positive outcomes especially for patients with cancer. Other strategies to restore function in exhausted CD8 T cells are currently under evaluation-many in combination with PD-1-targeted therapy. Exhausted CD8 T cells comprise heterogeneous cell populations with unique differentiation and functional states. A subset of stem cell-like PD-1

19 Review Analyzing Mouse B Cell Responses Specific to LCMV Infection. 2018

Hao, Yaxing / Li, Zhirong / Wang, Yifei / Liu, Xiaobing / Ye, Lilin. ·Institute of Immunology, Third Military Medical University, Gaotanyan, Shapingba District, Chongqing, 400038, China. · The First Affiliated Hospital, Biomedical Translational Research Institute and, Guangdong Province Key Laboratory of Molecular Immunology and Antibody Engineering, Jinan University, Guangzhou, 510632, China. · Institute of Immunology, Third Military Medical University, Gaotanyan, Shapingba District, Chongqing, 400038, China. yelilinlcmv@tmmu.edu.cn. ·Methods Mol Biol · Pubmed #29388097.

ABSTRACT: B cell responses play a central role in humoral immunity, which protects an individual from invading pathogens by antigen-specific antibodies. Understanding the basic principles of the B cell responses during viral infection is of substantial importance for anti-viral vaccine development. In inbred mice, lymphocytic choriomeningitis virus (LCMV) infection elicits robust and typical T cell-dependent B cell responses, including germinal center reaction, memory B cell formation, and a long-lived plasma cell pool in bone marrow. Therefore, this system represents an ideal model to investigate anti-viral B cell responses. In this protocol, we describe how to propagate and quantify LCMV and successfully establish an acute LCMV infection in mice. This protocol also provides three different techniques to analyze B cell responses specific to an acute LCMV infection: the identification of germinal center (GC) B cells and follicular helper CD4 T (T

20 Review Meningoencephaloradiculitis following infection with tick borne encephalitis virus: case report and review of the literature. 2018

Du Four, Stephanie / Mertens, Rembert / Wiels, Wietse / De Keyser, Jacques / Bissay, Veronique / Flamez, Anja. ·Department of Neurosurgery, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. Stephanie.Du.Four@vub.be. · Department of Infectious Diseases and Internal Medicine, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. · Department of Neurology, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. ·Acta Neurol Belg · Pubmed #29313244.

ABSTRACT: Tick borne encephalitis (TBE) is an infectious zoonotic disease caused by an RNA virus that is endemic to Central and Eastern Europe, Russia, and large parts of Asia. The tick borne encephalitis virus (TBEV) is transmitted through the saliva of infected ticks and infected goat milk. In the vast majority of cases, an infection with TBEV has a subclinical course. However, in some cases, it leads to neurological symptoms due to meningitis, meningoencephalitis, meningoencephalomyelitis, or meningoencephaloradiculitis. Here, we present the first case of meningoencephaloradiculitis in Belgium.

21 Review Herpes zoster meningitis in immunocompetent children: Two case reports and a literature review. 2017

Itoh, Naohiro / Motokura, Kouji / Kumakura, Akira / Hata, Daisuke / Hata, Atsuko. ·Department of Pediatrics, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka City, Osaka, Japan. ·Pediatr Int · Pubmed #29081071.

ABSTRACT: We encountered two cases of Herpes zoster (HZ) meningitis, a rarely occurring complication of HZ, in previously healthy children. One patient treated with i.v. acyclovir (ACV, 31 mg/kg/day) did not recover. His symptoms were relieved somewhat by increased ACV dosage, but it caused transient renal dysfunction. Another patient treated with i.v. ACV (30 mg/kg/day) recovered. Treatment for HZ meningitis in immunocompetent children has not been established. In a literature review, 80% of 20 patients were treated with the usual dose of ACV 15-30 mg/kg/day. The present cases suggest that a high dosage of ACV up to 60 mg/kg/day should be considered (while monitoring for side-effects) unless symptoms improve. In the review, one of every three vaccine-strain Varicella zoster virus (VZV) cases was severe, whereas the present cases resulted from wild type. Further investigations must examine different clinical characteristics of HZ meningitis caused by wild-type and vaccine-strain VZV.

22 Review Impact of meningitis on intelligence and development: A systematic review and meta-analysis. 2017

Christie, Deborah / Rashid, Harunor / El-Bashir, Haitham / Sweeney, Faye / Shore, Tim / Booy, Robert / Viner, Russell M. ·UCL Institute of Epidemiology & Health Care, London, United Kingdom. · National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, Westmead, Australia. · Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. · Rehabilitation Department, Al Jalila Children Specialty Hospital, Dubai, UAE. · UCL Institute of Child Health, London, United Kingdom. ·PLoS One · Pubmed #28837564.

ABSTRACT: BACKGROUND: We undertook a systematic review and meta-analysis to address the question "what is the impact of meningitis on IQ and development." METHODS: Search: conducted using standardized search terms across Medline, PsychInfo and EMBASE to 06/2014. Eligibility: human studies of any infectious aetiology of meningitis reporting IQ or infant developmental age or stage outcomes. Quality: Centre for Evidence Based Medicine, Oxford, quality tools. Analysis: random effects meta-analysis by organism. RESULTS: 39 studies were included in the review, 34 providing data on IQ (2015 subjects) and 12 on developmental delay (382 subjects). Across all bacterial organisms, meningitis survivors had a mean IQ 5.50 (95% CI: -7.19, -3.80; I2 = 47%, p = 0.02) points lower than controls. IQ was significantly lower than controls for Neisseria meningitides (NM: 5 points) and Haemophilus influenzae b (Hib: 6 points) but not in viral meningitis, with only single studies included for Streptococcus pneumoniae (SP) and group B streptococcus (GBS). The pooled relative risk (RR) for low IQ (IQ<70) in survivors of bacterial meningitis compared with controls was 4.99 (95% CI: 3.17, 7.86) with no significant heterogeneity (I2 = 49%, p = 0.07). Developmental delay of approximately 0.5SD was reported in studies of bacterial meningitis but no delay in the only study of viral meningitis. CONCLUSIONS: We found moderate evidence that surviving bacterial meningitis has a deleterious impact on IQ and development but no evidence that viral meningitis had meaningful cognitive impacts. Survivors of bacterial meningitis should be routinely offered screening for cognitive deficits and developmental delay in addition to hearing loss.

23 Review Hepatitis E virus and neurological disorders. 2017

Mclean, Brendan N / Gulliver, James / Dalton, Harry R. ·Neurology Department, The Royal Cornwall Hospitals NHS Trust, Truro, UK. · Gastroenterology Department, The Royal Cornwall Hospitals NHS Trust, Truro, UK. · European Centre for Environment and Human Health, University of Exeter, Truro, UK. ·Pract Neurol · Pubmed #28647707.

ABSTRACT: Hepatitis E is the most common cause of hepatitis worldwide. While originally considered a disease of developing countries, it is increasingly recognised in developed countries, probably related to contaminated pork meat, and where infection is often asymptomatic. However, several non-liver manifestations have become apparent, the most important of which are neurological, including Guillain-Barré syndrome (acute inflammatory demyelinating polyradiculoneuropathy (AIDP)), neuralgic amyotrophy and meningoencephalitis. We recommend testing all patients with AIDP and neuralgic amyotrophy for hepatitis E and consider testing any patient with an unexplained neurological illness and abnormal liver function tests for the virus.

24 Review Viral meningitis: current issues in diagnosis and treatment. 2017

McGill, Fiona / Griffiths, Michael J / Solomon, Tom. ·aInstitute of Infection and Global Health, University of Liverpool bNational Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections, University of Liverpool cRoyal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool dLeeds Teaching Hospitals NHS Trust, Leeds eAlderhey Children's NHS Foundation Trust fThe Walton Centre NHS Foundation Trust, Liverpool, UK. ·Curr Opin Infect Dis · Pubmed #28118219.

ABSTRACT: PURPOSE OF REVIEW: The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome. RECENT FINDINGS: Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions. Despite improvements in diagnostics many laboratories do not use molecular methods and even when they are used many cases still remain without a proven viral aetiology identified. There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial. SUMMARY: Viruses are in increasingly important cause of meningitis in the era of declining bacterial disease. The exact viral aetiology varies according to age and country. Molecular diagnostics can not only improve the rate of pathogen detection but also reduce unnecessary antibiotics use and length of hospitalization. Further research is required into treatments for viral meningitis and the impact in terms of longer term sequelae.

25 Review Fifteen-minute consultation: enterovirus meningitis and encephalitis-when can we stop the antibiotics? 2017

Drysdale, Simon B / Kelly, Dominic F. ·Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK. · NIHR Oxford Biomedical Research Centre, Level 2, Children's Hospital, Oxford, UK. ·Arch Dis Child Educ Pract Ed · Pubmed #27789515.

ABSTRACT: Enterovirus (EV) is the most common cause of aseptic meningitis and has a benign course, unlike EV encephalitis, which can result in long-term neurological sequelae. There are no active treatments or prophylactic agents, and management is purely supportive. Obtaining an EV-positive cerebrospinal fluid result usually allows antimicrobial treatment to be stopped. This review will answer some of the common questions surrounding EV meningitis/encephalitis.