Acute encephalopathy with biphasic seizures and late reduced diffusion associated with Streptococcus sanguinis sepsis

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) develops in association with systemic as well as central nervous system (CNS) viral or bacterial infections. AESD is most often noted with influenza or human herpesvirus 6 infection in previously healthy infants. However, AESD has also been reported in an infant with developmental retardation and in a mentally and motor-disabled adolescent. Here, we report the case of a 4-year-old female with significant development delay due to spinal muscular atrophy, who developed AESD during Streptococcus sanguinis sepsis with no apparent CNS infection. Although the patient had extremely high serum procalcitonin (45.84 ng/mL, reference; <0.4) on admission indicating a poor prognosis, she was successfully managed for sepsis and AESD.

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HUMAN HERPESVIRUS 7 RELATED ACUTE ENCEPHALOPATHY WITH BIPHASIC SEIZURES AND LATE REDUCED DIFFUSION

10.26226/morressier.58fa1768d462b80290b50c22 ◽

2017 ◽

Author(s):

Garyfallia Syridou

Keyword(s):

Human Herpesvirus ◽

Acute Encephalopathy

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Cytokine and chemokine responses in the blood and cerebrospinal fluid of patients with human herpesvirus 6B-associated acute encephalopathy with biphasic seizures and late reduced diffusion

Journal of Medical Virology ◽

10.1002/jmv.23788 ◽

2013 ◽

Vol 86 (3) ◽

pp. 512-518 ◽

Cited By ~ 19

Author(s):

Yoshiki Kawamura ◽

Yumie Yamazaki ◽

Masahiro Ohashi ◽

Masaru Ihira ◽

Tetsushi Yoshikawa

Keyword(s):

Cerebrospinal Fluid ◽

Human Herpesvirus ◽

Acute Encephalopathy

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Viruses Causing Aseptic Meningitis: A Tertiary Medical Center Experience With a Multiplex PCR Assay

Frontiers in Neurology ◽

10.3389/fneur.2020.602267 ◽

2020 ◽

Vol 11 ◽

Author(s):

Mohammed A. Aldriweesh ◽

Edi A. Shafaay ◽

Saud M. Alwatban ◽

Obeid M. Alkethami ◽

Faisal N. Aljuraisi ◽

...

Keyword(s):

Multiplex Pcr ◽

Aseptic Meningitis ◽

Medical Center ◽

Human Herpesvirus ◽

Length Of Hospital Stay ◽

Diagnostic Methods ◽

Cns Infection ◽

Unknown Etiology ◽

Molecular Testing ◽

Multiplex Pcr Assay

Background: Central nervous system (CNS) infection is associated with high rates of morbidity and mortality, and despite advancements in molecular testing, aseptic meningitis remains challenging to diagnose. Aseptic meningitis cases are often underreported worldwide, which impacts the quality of patient care. Therefore, we aimed to assess the results of BioFire® FilmArray® meningitis/encephalitis (ME) PCR panel, clinical characteristics, and etiologies of aseptic meningitis patients.Methods: From January 2018 to January 2020, all pediatric and adult patients in a large tertiary medical center who underwent lumbar puncture and cerebrospinal fluid (CSF) testing by a ME multiplex PCR panel and who fit the aseptic meningitis definition were retrospectively reviewed.Results: Data were reviewed from 1,607 patients; 240 met the inclusion criteria (54.6% males; 68.8% <4 years of age). The rate of detected viral causes of aseptic meningitis was 40.4%; therefore, 59.6% of the patients remained with unidentified etiology. Among the identified viral meningitis, enterovirus and human herpesvirus 6 (HHV-6) were the most common (25 and 7.9%, respectively). The median length of hospital stay was 6 days, and it was longer in patients with unidentifiable aseptic meningitis (p < 0.0001).Conclusion: Aseptic meningitis is common among suspected meningitis patients, but most cases remained of unknown etiology. The most common identified viruses were enterovirus followed by HHV-6, and there is predominance in males and the pediatric age group. These results highlight that further research is needed to identify other etiologies and possible additional viral pathogens for aseptic meningitis in the current diagnostic methods.

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Alternating Hemiplegia of Childhood: A Series of Genetically Confirmed Four Cases from Southern India with Review of Published Literature

Journal of Pediatric Genetics ◽

10.1055/s-0040-1714702 ◽

2020 ◽

Author(s):

Naveen Kumar Bhardwaj ◽

Vykuntaraju K. Gowda ◽

Ashwin Vivek Sardesai

Keyword(s):

Neurodevelopmental Disorder ◽

Response To Treatment ◽

Brain Response ◽

Significant Development ◽

Delay In Diagnosis ◽

Alternating Hemiplegia Of Childhood ◽

Development Delay ◽

The Brain ◽

Atp1a3 Gene

AbstractAlternating hemiplegia of childhood (AHC) is a rare autosomal dominant neurodevelopmental disorder with mutation on ATP1A3 gene. Delay in diagnosis and inappropriate diagnosis are common. We describe four genetically confirmed AHC patients to provide an improved understanding of the disorder. First symptom in two patients was seizures and in other two patients was abnormal eye deviation. All had onset of plegic attacks within the first 18 months of their life. Tone abnormalities and movement disorders were present in all patients. Electroencephalogram was abnormal in two patients and all had normal magnetic resonance imaging of the brain. Response to treatment of plegic attacks was poor and also epilepsy was drug resistant. All cases had significant development delay and disability as of last follow-up. Although there is no effective treatment so far, early diagnosis is required to avoid unnecessary treatment.

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Crab bite causing shewanella putrefaciens infection: Introduction to a possibly deadly and emerging threat

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00046 ◽

2020 ◽

Vol 8 (5_suppl5) ◽

pp. 2325967120S0004

Author(s):

Kamarul Arifin Abdul Razak ◽

Terence Michal Dass ◽

Tan Weng Liang ◽

Yogeshwarran Nadeson ◽

Karenjit Kaur

Keyword(s):

Soft Tissue ◽

Bacterial Infections ◽

Shewanella Putrefaciens ◽

Human Infection ◽

Cns Infection ◽

Soft Tissue Infections ◽

Normal Microflora ◽

Shewanella Species ◽

Antibiotics Susceptibility ◽

The Right

Shewanella species are gram-negative bacteria found in warm, temperate regions and are normal microflora of the marine environment1. Human infections are unusual and have a restricted geographic distribution. Presentation: A 45 years old lady was bitten by a crab while preparing to cook it. She developed fever and swelling of the right thumb with hemoserous discharge and blackish discolouration.Upon examination, the thumb was erythematous and swollen with a hematoma filled blister formation over the dorsal aspect. Deblistering was done and fluid samples were sent for culture and sensitivity which later returned as Shewanella Putrefaciens. Empirically she was started on IV Augmentin. Discussion: Most common clinical manifestation associated with Shewanella spp are superficial soft tissue infection1. Other reported clinical features are primary and secondary bacteremia, hepatobiliary, bone, joint and CNS infection, endocarditis, eye, ear and respiratory infection2. Antibiotics susceptibility includes aminoglycosides, 3rd and 4th generation cephalosporins, carbapenems and fluoroquinolones1. About 79% of patients have underlying conditions such as diabetes mellitus, venous congestion and heart failure; they are immunocompromised, as is our patient3. Conclusion: Proper handling of seafood during preparation should be encouraged as a simple bite may turn deadly. Initiation of antibiotics according to suspected organisms should be performed to prevent worsening of soft tissue infections. References: Diaz, J.H, Lopez, F.A Skin, Soft Tissue and Systemic Bacterial Infections Following Aquatic Injuries and Exposures. The American Journal of the Medical Sciences, 349(3), 269275 Finkelstein,R, Oren,I. Soft Tissue Infections Caused by Marine Bacterial Pathogens: Epidemiology, Diagnosis, and Management. Current Infectious Disease Report (2011)13(5):470–477 N. Vignier et al; Human Infection with Shewanella putrefaciens and S. algae: Report of 16 Cases in Martinique and Review of the Literature; Am. J. Trop. Med. Hyg., 89(1), 2013, pp. 151–156

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The Role of TLR4 Asp299Gly and TLR4 Thr399Ile Polymorphisms in the Pathogenesis of Urinary Tract Infections: First Evaluation in Infants and Children of Greek Origin

Journal of Immunology Research ◽

10.1155/2019/6503832 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Panagiota Karananou ◽

Despoina Tramma ◽

Socrates Katafigiotis ◽

Anastasia Alataki ◽

Alexandros Lambropoulos ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Bacterial Infections ◽

Pediatric Population ◽

Infants And Children ◽

Healthy Children ◽

Healthy Infants ◽

Tract Infections ◽

In Infants And Children

Urinary tract infections are one of the most common and serious bacterial infections in a pediatric population. So far, they have mainly been related to age, gender, ethnicity, socioeconomic level, and the presence of underlying anatomical or functional, congenital, or acquired abnormalities. Recently, both innate and adaptive immunities and their interaction in the pathogenesis and the development of UTIs have been studied. The aim of this study was to assess the role and the effect of the two most frequent polymorphisms of TLR4 Asp299Gly and Thr399Ile on the development of UTIs in infants and children of Greek origin. We studied 51 infants and children with at least one episode of acute urinary tract infection and 109 healthy infants and children. We found that 27.5% of patients and 8.26% of healthy children carried the heterozygote genotype for TLR4 Asp299Gly. TLR4 Thr399Ile polymorphism was found to be higher in healthy children and lower in the patient group. No homozygosity for both studied polymorphisms was detected in our patients. In the group of healthy children, a homozygote genotype for TLR4 Asp299Gly (G/G) as well as for TLR4 Thr399Ile (T/T) was showed (1.84% and 0.92 respectively). These results indicate the role of TLR4 polymorphism as a genetic risk for the development of UTIs in infants and children of Greek origin.

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Pasteurella multocidaand bovine respiratory disease

Animal Health Research Reviews ◽

10.1017/s1466252307001399 ◽

2007 ◽

Vol 8 (2) ◽

pp. 129-150 ◽

Cited By ~ 97

Author(s):

S. M. Dabo ◽

J. D. Taylor ◽

A. W. Confer

Keyword(s):

Respiratory Disease ◽

Bacterial Infections ◽

Pasteurella Multocida ◽

Extracellular Enzymes ◽

Bovine Respiratory Disease ◽

High Serum ◽

Stress Factors ◽

Field Efficacy ◽

Shipping Fever ◽

Colonization Factors

AbstractPasteurella multocidais a pathogenic Gram-negative bacterium that has been classified into three subspecies, five capsular serogroups and 16 serotypes.P. multocidaserogroup A isolates are bovine nasopharyngeal commensals, bovine pathogens and common isolates from bovine respiratory disease (BRD), both enzootic calf pneumonia of young dairy calves and shipping fever of weaned, stressed beef cattle.P. multocidaA:3 is the most common serotype isolated from BRD, and these isolates have limited heterogeneity based on outer membrane protein (OMP) profiles and ribotyping. Development ofP. multocida-induced pneumonia is associated with environmental and stress factors such as shipping, co-mingling, and overcrowding as well as concurrent or predisposing viral or bacterial infections. Lung lesions consist of an acute to subacute bronchopneumonia that may or may not have an associated pleuritis. Numerous virulence or potential virulence factors have been described for bovine respiratory isolates including adherence and colonization factors, iron-regulated and acquisition proteins, extracellular enzymes such as neuraminidase, lipopolysaccharide, polysaccharide capsule and a variety of OMPs. Immunity of cattle against respiratory pasteurellosis is poorly understood; however, high serum antibodies to OMPs appear to be important for enhancing resistance to the bacterium. Currently availableP. multocidavaccines for use in cattle are predominately traditional bacterins and a live streptomycin-dependent mutant. The field efficacy of these vaccines is not well documented in the literature.

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High serum levels of fatty acid–binding protein 7 in diabetic rats with experimental sepsis

European Journal of Inflammation ◽

10.1177/2058739218764235 ◽

2018 ◽

Vol 16 ◽

pp. 205873921876423

Author(s):

Emerson R Martins ◽

Thais M de Lima ◽

Hermes V Barbeiro ◽

Marcel C César Machado ◽

Fabiano Pinheiro da Silva

Keyword(s):

Fatty Acid ◽

Bacterial Infections ◽

Significant Proportion ◽

Cecal Ligation ◽

Diabetic Rats ◽

High Serum ◽

Diabetic Patients ◽

Experimental Sepsis ◽

Fatty Acid Binding ◽

Potential Biomarker

Sepsis is a disease that affects a wide variety of individuals, including the young, the elderly, and those admitted to the hospital with diverse acute or chronic conditions. Because sepsis is such a heterogeneous disease, some researchers believe that personalized medicine may represent a promising means of improving the prognosis for certain patients. Of those who develop sepsis, diabetic patients remain a significant proportion, because diabetes is a metabolic disorder that is associated with disturbances in the immune system, which facilitates bacterial infections. Fatty acid–binding proteins (FABPs) are a family of transport proteins with an important role in metabolism; therefore, we decided to measure their levels in diabetic rats, as part of a search for a novel biomarker of sepsis. Diabetes was experimentally induced in male Wistar rats, some of which then underwent cecal ligation and puncture, and the levels of FABP4 and FABP7 were measured in their serum and key tissues. Serum FABP7 levels in diabetic septic rats were significantly higher than those in non-diabetic septic rats. Consequently, we propose that FABP7 should be further investigated as a potential biomarker of sepsis in diabetic patients.

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Sepsis and meningoencephalitis due to Listeria monocytogenes in patients with liver cirrhosis: a case of nonhepatic encephalopathy?

Italian Journal of Medicine ◽

10.4081/itjm.2012.231 ◽

2012 ◽

Author(s):

Federico Lari ◽

Roberta Bortolotti ◽

Mariaelena Vacchetti ◽

Gianpaolo Bragagni ◽

Marco Lenzi

Keyword(s):

Cerebrospinal Fluid ◽

Liver Cirrhosis ◽

Hepatic Encephalopathy ◽

Listeria Monocytogenes ◽

Neurological Disorders ◽

Bacterial Infections ◽

Multiorgan Failure ◽

Immune Dysfunction ◽

Blood Cultures ◽

Cns Infection

Introduction The appearance of neurological disorders in a patient with liver cirrhosis initially suggests hepatic encephalopathy, but other causes should be considered, including bacterial infections.Materials and methods An 80-year-old woman suffering from HCV-related cirrhosis was admitted for fever, confusion, and stupor. No improvement was seen after treatment with cephalosporins, lactulose, and fluids.Results Listeria monocytogenes was isolated from blood cultures and subsequently from a cerebrospinal fluid specimen as well. On the basis of the antibiogram, the antibiotic therapy was modified to include ampicillin, but shock and multiorgan failure developed and the patient died one week later.Discussion Bacterial infections are more common and more aggressive in patients with liver cirrhosis, probably because of the immune dysfunction associated with this disorder. The presence of neurological disorders in a patient with liver cirrhosis may be a sign of hepatic encephalopathy, but it is important to recall that there are other potential causes as well, including bacterial infections. In this case, it is possible that the patient's symptoms were the result of the CNS infection with L. monocytogenes, which was particularly aggressive as a result of her cirrhosis.

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