Microsporidia-induced stromal keratitis: a new cause of presumed immune stromal (interstitial) keratitis

2021 ◽  
pp. bjophthalmol-2021-319784
Author(s):  
Amrita Mohanty ◽  
Himansu Sekhar Behera ◽  
Manas Ranjan Barik ◽  
Amanjot Kaur ◽  
Savitri Sharma ◽  
...  
Keyword(s):  
Clinical Features ◽  
Topical Steroids ◽  
Duration Of Symptoms ◽  
Corneal Epithelial ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Interstitial Keratitis ◽  
Stromal Keratitis ◽  
Epstein Barr ◽  
Simplex Virus

Background and objectiveTo describe the clinical features, diagnosis and management of immune stromal keratitis/interstitial keratitis (IK) associated with microsporidial epithelial keratitis.MethodsBetween October 2020 and January 2021, medical records of IK patients microbiologically proven as microsporidia from samples collected from corneal epithelium on smear examination, and/ or molecular analysis were reviewed. Demography, clinical profile and treatment were analysed. Real-time PCR (RT-PCR) for adenovirus (ADV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella-zoster virus (VZV) was done.ResultsTwenty of 152 (13%) microbiologically proven cases of microsporidial keratitis were diagnosed as IK during the study period, the mean age and duration of symptoms were 35.7±11.4 years and 46.3±27.7 days, respectively. Half had predisposing risk factors, like trauma; and 30% had prior recurrences. One-fourth of patients were using antivirals on presentation. Characteristic presentations included disciform keratitis(n=12), incomplete/complete ring(n=5), and combination(n=3), along with variable subepithelial infiltrates (n=14). All cases had stromal oedema, with an intact epithelium and fine pigment dusting on endothelium. Corneal epithelial scrapings had scanty microsporidia spores in smears of 17/20 (85%), and pan-microsporidial DNA was identified in 14/20 (70%), with Vittaforma corneae by sequencing in 11/20 (55%). Other viruses detected were ADV (14,70%), VZV (2,10%), EBV (1,5%) and HSV (1,5%). Rapid resolution of inflammation and oedema within 2 weeks of starting steroids was seen in all cases.ConclusionMicrosporidia epithelial keratitis induced stromal inflammatory keratitis; is distinguished from microsporidial keratoconjunctivitis and stromal keratitis, by characteristic clinical features, and response to topical steroids.

Select Viruses in Adults

2012 ◽  
pp. 61-79
Author(s):  
Randall C. Walker
Keyword(s):  
Viral Infections ◽  
Parvovirus B19 ◽  
Systemic Disease ◽  
Diagnostic Tools ◽  
Varicella Zoster ◽  
Epidemiologic Factors ◽  
Barr Virus ◽  
Epstein Barr ◽  
Simplex Virus

The following types of viral infections are discussed in this chapter: viral infections that have the capacity for multiorgan or systemic disease; infections that affect adults who may be otherwise healthy or at least not in special populations such as herpes simplex virus (HSV) type 1, varicella-zoster virus (VZV), Epstein-Barr virus, adenovirus, mumps virus, human parvovirus B19, and coxsackievirus. Reviews of these viruses focus on differentiating clinical features, diagnostic tools and treatment, and salient microbiologic and epidemiologic factors.

scholarly journals An overview of viral infections of the nervous system in the immunosuppressed

2020 ◽  
Author(s):  
Peter G. E. Kennedy
Keyword(s):  
Nervous System ◽  
Measles Virus ◽  
Viral Infections ◽  
Jc Virus ◽  
Virus Infections ◽  
Inborn Errors ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Epstein Barr ◽  
Simplex Virus

Abstract Several viruses have the capacity to cause serious infections of the nervous system in patients who are immunosuppressed. Individuals may be immunosuppressed because of primary inherited immunodeficiency, secondary immunodeficiency due to particular diseases such as malignancy, administration of immunosuppressant drugs or organ or bone marrow transplantation. The viruses capable of such opportunistic infection of the nervous system include herpes simplex virus (HSV), Varicella-Zoster virus (VZV), Cytomegalovirus (CMV), Epstein –Barr virus (EBV), Human Herpes virus type 6 (HHV-6), JC virus (JCV), enterovirus, measles virus and Covid-19. In most cases it seems likely that immunological defence mechanisms in the immunosuppressed are deficient which creates a suitable environment for certain viruses to become opportunistic in the nervous and other systems. Further research is required both to understand these opportunistic mechanisms in more detail and also to determine how many virus infections are modified by specific inborn errors of immunological responses.

scholarly journals Analytical methods in herpesvirus genomics

2014 ◽  
Vol 7 (2) ◽  
pp. 109-118
Author(s):  
Jana Blaškovičová ◽  
Ján Labuda
Keyword(s):  
Analytical Methods ◽  
Genome Structure ◽  
Human Herpesvirus ◽  
B Cell Lymphoma ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Epstein Barr ◽  
Simplex Virus ◽  
And Function ◽  
Analytical Approaches

Abstract Genomics is a branch of bioanalytical chemistry characterized as the study of the genome structure and function. Genome represents the complete set of chromosomal and extrachromosomal genes of an organism, a cell, an organelle or a virus. There are at least five from eight species of herpesviruses commonly widespread among humans, Herpes simplex virus type 1 and 2, Varicella zoster virus, Epstein-Barr virus and Cytomegalovirus. Human gammaherpesviruses can cause serious diseases including B-cell lymphoma and Kaposi’s sarcoma. Diagnostics and study of the herpesviruses is directly dependent on the development of modern analytical methods able to detect and determine the presence and evolution of herpesviral particles/ genomes. Diagnostics and genomic characterization of human herpesvirus species is based on bioanalytical methods such as polymerase chain reaction (PCR), DNA sequencing, gel electrophoresis, blotting and others. The progress in analytical approaches in the herpesvirus genomics is reviewed in this article.

Viral exposures and MS outcome in a prospective cohort of children with acquired demyelination

2015 ◽  
Vol 22 (3) ◽  
pp. 385-388 ◽  
Author(s):  
Naila Makhani ◽  
Brenda Banwell ◽  
Raymond Tellier ◽  
Carmen Yea ◽  
Suzanne McGovern ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Epstein Barr Virus ◽  
Protective Factor ◽  
Cmv Infection ◽  
Prognostic Information ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr ◽  
Simplex Virus

Epstein–Barr virus (EBV) infection is associated with increased multiple sclerosis (MS) risk. Recently, cytomegalovirus (CMV) infection has been proposed as a protective factor against MS development. We determined EBV, herpes simplex virus, varicella-zoster virus and CMV seroprevalence in 247 prospectively followed children with acquired demyelinating syndromes (ADS). Remote EBV infection was more common in children with MS than those with monophasic ADS while CMV infection was more common in children with monophasic ADS. Children displaying evidence of remote EBV without CMV infection were at highest risk of subsequent MS diagnosis. Viral infection repertoire detected at ADS provides important prognostic information.

scholarly journals Herpesvirus Infections of the Central Nervous System

2019 ◽  
Vol 39 (03) ◽  
pp. 369-382 ◽  
Author(s):  
Tehmina Bharucha ◽  
Catherine F. Houlihan ◽  
Judith Breuer
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Human Herpesvirus ◽  
Clinical Syndrome ◽  
Herpes Simplex Virus 1 ◽  
Varicella Zoster ◽  
Barr Virus ◽  
The Central Nervous System ◽  
Epstein Barr ◽  
Simplex Virus

AbstractThere are over 200 herpesvirus species, of which 10 affect humans. Each of these 10 herpesviruses has a unique clinical syndrome, but common to all is their ability to cause infection and pathology in the central nervous system. In this article, we discuss the epidemiology, clinical presentation, diagnostic modalities, treatment, sequelae, and availability of vaccination of each of the following herpesviruses: herpes simplex virus 1 and 2, varicella zoster virus, human cytomegalovirus, human herpesvirus 6A, 6B, and 7, Epstein–Barr virus, human herpesvirus 8, and simian herpesvirus B.

scholarly journals Polymerase chain reaction for the laboratory diagnosis of aseptic meningitis and encephalitis

2000 ◽  
Vol 58 (3B) ◽  
pp. 836-842 ◽  
Author(s):  
MARISA CHESKY ◽  
ROSANA SCALCO ◽  
LUCIANE FAILACE ◽  
STEVEN READ ◽  
LUIZ FERNANDO JOBIM
Keyword(s):  
Epstein Barr Virus ◽  
Jc Virus ◽  
Human Herpes ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Human Herpes Virus ◽  
Pcr Assays ◽  
Epstein Barr ◽  
Simplex Virus ◽  
Human Herpes Virus Type

A protocol for testing cerebrospinal fluid specimens using a range of PCR assays for the diagnosis of central nervous system infection was developed and used to test prospectively 383 specimens. PCR assays were used for the detection of adenovirus, Borrelia burgdorferi, enteroviruses, Epstein Barr virus, cytomegalovirus, herpes simplex virus, human herpes virus type 6, JC virus, Leptospira interrogans, Listeria monocytogenes, lymphocytic choriomeningitis virus, measles virus, mumps virus, Mycobacterium sp., Mycoplasma pneumoniae, Toxoplasma gondii and varicella zoster virus. Of the 383 specimens tested in this study, 46 (12.0%) were found to be positive. The microorganisms detected were CMV, enterovirus, Epstein Barr virus, herpes simplex virus, human herpes virus type 6, JC virus, L. monocytogenes, Mycobacterium genus, Toxoplasma gondii and varicella zoster virus. The introduction of the PCR protocol described has improved the diagnosis of a range of central nervous system infections in our laboratory. We believe however that further evaluation of these assays in immunocompromised patients is necessary to better determine the predictive value of positive PCR results in these patient groups.

scholarly journals Inhibition of Herpesvirus Replication by 5-Substituted 4′-Thiopyrimidine Nucleosides

2009 ◽  
Vol 53 (12) ◽  
pp. 5251-5258 ◽  
Author(s):  
Mark N. Prichard ◽  
Debra C. Quenelle ◽  
Caroll B. Hartline ◽  
Emma A. Harden ◽  
Geraldine Jefferson ◽  
...  
Keyword(s):  
Human Herpesvirus ◽  
Good Activity ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Resistant Strains ◽  
Epstein Barr ◽  
Simplex Virus ◽  
Hsv 1

ABSTRACT A series of 4′-thionucleosides were synthesized and evaluated for activities against orthopoxviruses and herpesviruses. We reported previously that one analog, 5-iodo-4′-thio-2′-deoxyuridine (4′-thioIDU), exhibits good activity both in vitro and in vivo against two orthopoxviruses. This compound also has good activity in cell culture against many of the herpesviruses. It inhibited the replication of herpes simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus with 50% effective concentrations (EC50s) of 0.1, 0.5, and 2 μM, respectively. It also inhibited the replication of human cytomegalovirus (HCMV) with an EC50 of 5.9 μM but did not selectively inhibit Epstein-Barr virus, human herpesvirus 6, or human herpesvirus 8. While acyclovir-resistant strains of HSV-1 and HSV-2 were comparatively resistant to 4′-thioIDU, it retained modest activity (EC50s of 4 to 12 μM) against these strains. Some ganciclovir-resistant strains of HCMV also exhibited reduced susceptibilities to the compound, which appeared to be related to the specific mutations in the DNA polymerase, consistent with the observed incorporation of the compound into viral DNA. The activity of 4′-thioIDU was also evaluated using mice infected intranasally with the MS strain of HSV-2. Although there was no decrease in final mortality rates, the mean length of survival after inoculation increased significantly (P < 0.05) for all animals receiving 4′-thioIDU. The findings from the studies presented here suggest that 4′-thioIDU is a good inhibitor of some herpesviruses, as well as orthopoxviruses, and this class of compounds warrants further study as a therapy for infections with these viruses.

scholarly journals A Randomized Double-Blind Placebo Controlled Trial of Oral Acyclovir in Renal Allograft Recipients

1993 ◽  
Vol 4 (2) ◽  
pp. 84-88 ◽  
Author(s):  
Walter F Schlech ◽  
Nancy Meagher ◽  
Allan D Cohen ◽  
Philip Belitsky ◽  
AS MacDonald ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Varicella Zoster Virus ◽  
Epstein Barr Virus ◽  
Oral Acyclovir ◽  
Cmv Infection ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Epstein Barr ◽  
Simplex Virus

Fifty renal transplant patients were randomized to receive either 800 mg acyclovir by mouth four times daily or identical placebo tablets for prophylaxis of herpes simplex infection. Patients were followed weekly to assess reactivation of herpes simplex, varicella zoster virus, Epstein-Barr virus or cytomegalovirus (CMV) infections. The patients received standard immunosuppressive regimens including cyclosporine A. Acyclovir suppressed secretion of herpes simplex virus in treated patients (P=0.001). Three episodes of mucocutaneous herpes simplex virus occurred in placebo recipients and one in a noncompliant acyclovir recipient. A clinically important difference in graft survival was demonstrated, but because of sample size failed to reach statistical significance (P=0.11). No reactivation of varicella zoster virus, Epstein-Barr virus or CMV infection was detected in either group. Toxicity was limited to central nervous irritability. The authors conclude that high dose oral acyclovir provides effective prophylaxis for prevention of herpes simplex virus infections in renal transplantation and may be associated with increased graft survival, perhaps from suppression of CMV infection.

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