Acta Medica Leopoliensia (Aug 2017)

Clinical and laboratory characteristics of acute herpes neuroinfections

  • V.M. Koz'ko,
  • A.V. Sokhan,
  • I.J. Yaremko,
  • A.A. Kuznetsova,
  • A.V. Gavrilov,
  • Y.I. Kopiychenko,
  • V.V. Pavlov,
  • L.I. Markush

DOI
https://doi.org/10.25040/aml2017.03.039
Journal volume & issue
Vol. 23, no. 3
pp. 39 – 44

Abstract

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Aim. To determine the clinical and laboratory features of herpes viral neuroinfections, depending on the etiology and severity of the disease. Material and Methods. The study included 68 patients with acute herpes viral meningitis and meningoencephalitis. The etiology of the disease was confirmed by PCR of the patients' cerebrospinal fluid. In the group of 216 HIV-negative patients with serous meningitis and meningoencephalitis in 20 patients was found herpes simplex virus, in 16 - Epstein-Barr virus, in 14 - human herpes virus type 6, in 13 - herpes zoster virus and in 5 - cytomegalovirus. We analyzed the clinical picture and indicators of blood and cerebrospinal fluid on the first day of hospitalization. Results and Discussion. Herpes viral etiology of neuroinfection was diagnosed in 31,48% of patients with serous meningitis and meningoencephalitis. Among all patients, moderate disease was diagnosed in 46 (67,65%) of patients; 22 (32,35%) patients presented with severe disease; 5 (7,35%) patients died. The average age of patients was 35,52±1,87 years. The largest number of severe cases was observed in patients with EBV, CMV and HHV-6 CNS infections - 50%, 40% and 35,71%, respectively. Moderate course of the disease was characterized by acute onset with moderate symptoms of intoxication, general brain symptoms and mild meningeal symptoms. Patients with severe disease on 3-7 day presented with brain edema and various cerebral focal symptoms of central nervous system lesions. Conclusions. Herpes viral infections of central nervous system occur frequently and are among the most serious viral neuroinfections in Ukraine. Prevalence of HSV 1,2, EBV and HHV-6 meningitis and meningoencephalitis is the highest among herpes viral infections. In the group of acute herpes simplex virus neuroinfections, 90 percent of all cases are observed in women. At the same time, 76% of all cases of herpes zoster neuroinfections are observed in men. HHV-6 neuroinfection is accompanied by frequent development of residual intellectual and mental disorders, and hallucinatory syndrome.

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