Hurst’s encephalitis. Lecture with a description of clinical cases

2021 ◽  
Vol 2 (2) ◽  
pp. 89-93
Author(s):  
Eugenia A. Komarova ◽  
Alexey S. Kotov
Keyword(s):  
White Matter ◽  
Severe Disease ◽  
Intensive Therapy ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Acute Onset ◽  
Brain Hemispheres ◽  
First Case ◽  
The Brain ◽  
Clinical Cases

Hirst’s encephalitis is a severe disease characterized by an acute onset and rapidly progressive inflammation with symmetrical multifocal lesions of the brain, less often the cerebellum, brain stem, or spinal cord, manifested by white matter necrosis and numerous hemorrhages. Cases of Hirst’s encephalitis are quite rare; by 2014, about 100 cases of the disease have been described in the literature. The mortality rate for this disease reaches 70%. Its etiology remains unclear, and in most cases, the diagnosis is made heuristically, based on the similarity of clinical manifestations in a particular patient with the “classical” descriptions available in the literature. The article presents two clinical cases of Hirst’s encephalitis. In the first case, the disease debuted at the age of 14 with mental disorders, manifested by panencephalitis, depression of consciousness, and epileptic seizures. Against the background of aggressive therapy, it was possible to achieve a positive result, however, with an outcome in gross neurological and cognitive deficits. In the second case, the disease debuted at the age of 49 with loss of consciousness, manifested itself as resistant status epilepticus and multifocal inflammatory lesions of the white matter of both brain hemispheres with foci of hemorrhagic impregnation. Despite intensive therapy, this case was fatal. In conclusion, a description of the approaches to the diagnosis and treatment of Hirst’s encephalitis based on the data of modern literature is presented.

scholarly journals Staphylococcus intermedius Brain Abscess as a Complication of Pulmonary Arteriovenous Malformation in a Patient With Hereditary Hemorrhagic Telangiectasia

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Leon S Moskatel ◽  
Joslyn N Vo ◽  
Keshav R Nayak ◽  
Nancy F Crum-Cianflone
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Clinical Manifestations ◽  
Complete Recovery ◽  
Pulmonary Arteriovenous Malformation ◽  
Staphylococcus Intermedius ◽  
First Case ◽  
Human Infections ◽  
The Brain

Abstract Staphylococcus intermedius is a rare cause of human infections ranging from skin and soft tissue infections to bacteremia. It is particularly known for its association with exposure to dogs. We report an unusual case of a 73-year-old female with a brain abscess caused by S intermedius who was recently diagnosed with hereditary hemorrhagic telangiectasia and a pulmonary arteriovenous malformation. The patient underwent debridement of the brain abscess followed by a 6-week course of vancomycin and rifampin, after which she made a near complete recovery. This is the first case of a brain abscess in an adult due to S intermedius in the published literature, and we provide a comprehensive review of the literature of all human infections caused by this pathogen and summarize its clinical manifestations, treatment recommendations, and outcomes.

scholarly journals The clinical manifestations of nervous system mesenchyme syphilis

2002 ◽  
Vol 1 (2) ◽  
pp. 77-82
Author(s):  
T. A. Valikova ◽  
V. M. Alifirova ◽  
I. M. Fyodorova ◽  
N. Yu. Paimursina
Keyword(s):  
Nervous System ◽  
Progressive Disease ◽  
Clinical Manifestations ◽  
Pathological Process ◽  
Acute Stage ◽  
Pathologic Process ◽  
First Case ◽  
Brain Substance ◽  
Chronic Progressive Disease ◽  
The Brain

Nervous system syphilis — neurosyphilis (NS) belongs to rather rare diseases. According to the different authors data available it comes to about 1% of the nervous system organic disturbances and develops by 5—10% syphilous patients not having been treated in the acute stage of the pathological process. The syphilitic disturbance of the nervous system is a chronic progressive disease caused by the pale spirochaeta. The nervous system disturbance occurs basically in two ways: secondary one, because of brain shells, vessels, gummatous manifestations involving in the pathologic process; or primary one, when the causative agent affects directly the brain substance. In the first case syphilis is called rnesodermic or early one; in the second case — parenchymatous or late, primary one. In the article the analysis of two clinical cases of mesenchyme neurosyphilis is carried out: latent neurosyphilis and syphilitic meningomyelitis. Neurosyphilis classification is applied to clinical manifestatons of syphilitic arachnoiditis and vasculitis are described. The methods of specific and nonspecific therapy of mesenchyme syphilis are stated in detail.

scholarly journals Enterobacter cloacae Endophthalmitis: Report of Four Cases

1998 ◽  
Vol 36 (1) ◽  
pp. 48-51 ◽  
Author(s):  
N. Okhravi ◽  
L. Ficker ◽  
M. M. Matheson ◽  
S. Lightman
Keyword(s):  
Severe Disease ◽  
Visual Outcome ◽  
Enterobacter Cloacae ◽  
Acute Onset ◽  
Rapid Progression ◽  
Gram Negative ◽  
Severe Visual Loss ◽  
Ocular Symptoms ◽  
First Case ◽  
Resistance To Infection

Members of the genus Enterobacter are commensal organisms of the gastrointestinal tract and are considered pathogenic only for patients with lowered resistance to infection (e.g., chronic infection, cancer, or diabetes mellitus) or those with impaired immunity (congenital, acquired, or impaired immunity secondary to therapy). We report on four cases of endophthalmitis caused byEnterobacter cloacae: two in patients with acute postoperative endophthalmitis, one in a patient with delayed bleb-related endophthalmitis, and one in a patient presenting with presumed posttraumatic endophthalmitis. Each patient presented with severe disease many days after the onset of ocular symptoms, and two patients had systemic risk factors accounting for a reduced resistance to infection. Endophthalmitis caused by gram-negative bacilli is characterized by acute onset, rapid progression, and poor final visual outcome. Each of these patients was treated by a standard protocol with intravitreal, systemic, and topical antibiotics and systemic steroids. Despite treatment, the final visual outcomes for three of these patients was no perception of light, and that for one patient remained perception of hand movements only. In common with endophthalmitis caused by other gram-negative organisms, intraocular infection secondary to Enterobacter cloacae infection is a devastating disease which, despite treatment, results in extensive ocular damage and severe visual loss. Since 1966, only four cases of endophthalmitis secondary to infection with members of this genus have been reported. This report presents four cases which occurred over a period of 14 months and, to the best of our knowledge, the first case of bleb-related endophthalmitis secondary to E. cloacaeinfection.

scholarly journals Case Report: A Homozygous Mutation (p.Y62X) of Phospholipase D3 May Lead to a New Leukoencephalopathy Syndrome

2021 ◽  
Vol 13 ◽  
Author(s):  
Yi-Hui Liu ◽  
Hai-Feng Zhang ◽  
Jie-Yuan Jin ◽  
Yan-Qiu Wei ◽  
Chen-Yu Wang ◽  
...  
Keyword(s):  
Case Report ◽  
White Matter ◽  
Kidney Disease ◽  
Messenger Rna ◽  
Vision Loss ◽  
Clinical Manifestations ◽  
White Matter Lesions ◽  
Homozygous Mutation ◽  
Inherited Disorders ◽  
First Case

Leukodystrophies are a heterogeneous group of inherited disorders with highly variable clinical manifestations and pathogenetic backgrounds. At present, variants in more than 20 genes have been described and may be responsible for different types of leukodystrophies. Members of the phospholipase D family of enzymes catalyze the hydrolysis of membrane phospholipids. Meanwhile, phospholipase D3 (PLD3) has also been found to exhibit single stranded DNA (ssDNA) acid 5′ exonuclease activity. Variants in phospholipase D3 (PLD3) may increase the risk of Alzheimer's disease and spinocerebellar ataxia, but this hypothesis has not been fully confirmed. In this study, we identified a novel homozygous mutation (NM_012268.3: c.186C>G/ p.Y62X) of PLD3 in a consanguineous family with white matter lesions, hearing and vision loss, and kidney disease by whole exome sequencing. Real-time PCR revealed that the novel mutation may lead to non-sense-mediated messenger RNA (mRNA) decay. This may be the first case report on the homozygous mutation of PLD3 in patients worldwide. Our studies indicated that homozygous mutation of PLD3 may result in a novel leukoencephalopathy syndrome with white matter lesions, hearing and vision loss, and kidney disease.

scholarly journals Clinical characteristics of foodborne botulism in the southern region of the Kyrgyz Republic

2020 ◽  
Vol 10 (3) ◽  
pp. 581-586
Author(s):  
S. T. Salieva ◽  
S. T. Zholdoshev
Keyword(s):  
Incubation Period ◽  
Disease Severity ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Southern Region ◽  
Nasolabial Fold ◽  
Kyrgyz Republic ◽  
Short Incubation Period ◽  
Hands And Feet

The main factors of botulism transmission are identified as home-canned products (vegetable salads, fruit compotes, seaberry jam), pickled cucumbers and tomatoes. Botulism proceeds clinically as moderate-to-severe disease. High prevalence of type A and untypeable C. botulinum toxins along with type B species in the southern region accounts for its severe course. In our study, clinical manifestations of botulism were presented by moderate and severe clinical picture in 72.3% (47 patients) and 27.7% (18 patients) cases. No mild forms of the disease were diagnosed. Length of incubation period in examined patients on average was 13.6 hours. Upon that, a short incubation period was observed after consumption of canned fruit compote and sea buckthorn jam, cucumbers and tomatoes (16 subjects) or canned vegetables (38 subjects) on average ranging from 4 to 8 hours, 8 hours to 1 day, or 15 hours to 1.5 days, respectively. All subjects were featured with acute onset manifested as general intoxication and gastrointestinal syndromes. The former was characterized by headache, dizziness, and severe general weakness. Subfebrile temperature (37.1–37.5°C) was noted in patients with a short incubation period. Such syndrome in case of moderate disease course was also characterized by moderate severity in 70.2±6.7% cases, with acute appearance in 29.8±6.9% cases; in severe course it was featured with extremely severe course (100%), and in one case it resulted in lethal outcome. Intensity and persistence of neurological disorders clearly correlated with the disease severity, which pointed at its progression. Upon admission to the hospital, patients noted moderate and marked dry mouth in 63.1±5.9% and 36.9±5.9% cases, respectively. Ophthalmoplegic syndrome was characterized by: doubling of object contours, diplopia, limited eye movement, mydriasis, lethargy or lack of pupillary reaction to light, anisocoria, and ptosis. Phagonazoglossoneurological syndrome was early manifested by swallowing problem. Next, tongue deviation, amimia, flattened nasolabial fold, and soft palate paresis were added up. Phonolaryngology syndrome was evident depending on disease severity in a form of varying intensity of dysphonia and dysarthria. Syndrome of general myoneuroplegia was characterized by lowered strength in hands and feet.

scholarly journals Modern neurogenetic representations of MELAS syndrome. Clinical cases (the lecture)

2020 ◽  
Vol 14 (4) ◽  
pp. 26-31
Author(s):  
A. V. Shatalin ◽  
E. V. Mukhina ◽  
A. S. Kotov ◽  
M. G. Amirkhanyan
Keyword(s):  
Metabolic Diseases ◽  
Mitochondrial Diseases ◽  
Epileptic Seizures ◽  
Hereditary Disease ◽  
Melas Syndrome ◽  
Genetic Interpretation ◽  
Hereditary Metabolic Diseases ◽  
Early Dementia ◽  
The Brain ◽  
Clinical Cases

This lecture with a description of clinical cases presents information on such a mitochondrial disease from the group of hereditary metabolic diseases, like MELAS syndrome (OMIM: 540000). The main manifestations of this progressive disease are stroke-like episodes and a specific form of encephalopathy, including epileptic seizures with the presence of a phenomenon of "ragged red fibers" and early dementia. Clinical cases, given in this lecture, supplement the piggy bank of genetically verified mitochondrial diseases leading to the development of polymorphic neurological disorders and characteristic neuroimaging picture, namely the appearance of polymorphic ischemic changes in the temporal, parietal or occipital regions of the brain, that do not correspond to the zones of the main vascular blood supply, as the basis for the formation of such focus is the phenomenon of mitochondrial angiopathy, and not thrombosis. The description of clinical cases reflects our own observations and the main steps in the diagnosis of this severe hereditary disease, taking into account of the latest neurogenetic representations. In addition to the data given in the clinical course of the disease, the results of the genetic interpretation of the MELAS syndrome are given; modern methods of diagnosis and therapy are considered.

scholarly journals Induced Neurocysticercosis in Rhesus Monkeys (Macaca mulatta) Produces Clinical Signs and Lesions Similar to Natural Disease in Man

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
N. Chowdhury ◽  
A. Saleque ◽  
N. K. Sood ◽  
L. D. Singla
Keyword(s):  
Macaca Mulatta ◽  
Rhesus Monkeys ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Cognitive Responses ◽  
Chronic Inflammatory Response ◽  
Experimental Animal Models ◽  
Liquefactive Necrosis ◽  
The Brain

Neurocysticercosis is a serious endemic zoonosis resulting in increased cases of seizure and epilepsy in humans. The genesis of clinical manifestations of the disease through experimental animal models is poorly exploited. The monkeys may prove useful for the purpose due to their behavior and cognitive responses mimicking man. In this study, neurocysticercosis was induced in two rhesus monkeys each with 12,000 and 6,000 eggs, whereas three monkeys were given placebo. The monkeys given higher dose developed hyperexcitability, epileptic seizures, muscular tremors, digital cramps at 10 DPI, and finally paralysis of limbs, followed by death on 67 DPI, whereas the monkeys given lower dose showed delayed and milder clinical signs. On necropsy, all the infected monkeys showed numerous cysticerci in the brain. Histopathologically, heavily infected monkeys revealed liquefactive necrosis and formation of irregular cystic cavities lined by atrophied parenchymal septa with remnants of neuropil of the cerebrum. In contrast, the monkeys infected with lower dose showed formation of typical foreign body granulomas characterized by central liquefaction surrounded by chronic inflammatory response. It was concluded that the inflammatory and immune response exerted by the host against cysticerci, in turn, led to histopathological lesions and the resultant clinical signs thereof.

scholarly journals Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation

2021 ◽  
Vol 8 ◽  
Author(s):  
Om Prakash Mehta ◽  
Parshal Bhandari ◽  
Akshay Raut ◽  
Salah Eddine Oussama Kacimi ◽  
Nguyen Tien Huy
Keyword(s):  
Viral Entry ◽  
Clinical Presentation ◽  
Early Stage ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Endocrine System ◽  
Extensive Literature ◽  
First Case ◽  
Clinical Presentations ◽  
Organ Systems

COVID-19 is a rapidly growing pandemic with its first case identified during December 2019 in Wuhan, Hubei Province, China. Due to the rampant rise in the number of cases in China and globally, WHO declared COVID-19 as a pandemic on 11th March 2020. The disease is transmitted via respiratory droplets of infected patients during coughing or sneezing and affects primarily the lung parenchyma. The spectrum of clinical manifestations can be seen in COVID-19 patients ranging from asymptomatic infections to severe disease resulting in mortality. Although respiratory involvement is most common in COVID-19 patients, the virus can affect other organ systems as well. The systemic inflammation induced by the disease along with multisystem expression of Angiotensin Converting Enzyme 2 (ACE2), a receptor which allows viral entry into cells, explains the manifestation of extra-pulmonary symptoms affecting the gastrointestinal, cardiovascular, hematological, renal, musculoskeletal, and endocrine system. Here, we have reviewed the extensive literature available on COVID-19 about various clinical presentations based on the organ system involved as well as clinical presentation in specific population including children, pregnant women, and immunocompromised patients. We have also briefly discussed about the Multisystemic Inflammatory Syndrome occurring in children and adults with COVID-19. Understanding the various clinical presentations can help clinicians diagnose COVID-19 in an early stage and ensure appropriate measures to be undertaken in order to prevent further spread of the disease.

scholarly journals Babesiain a Nonsplenectomized Patient Requiring Exchange Transfusion

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Dikshya Sharma ◽  
Bindu Mudduluru ◽  
Elias Moussaly ◽  
Neville Mobarakai ◽  
Matthew Hurford
Keyword(s):  
Exchange Transfusion ◽  
Immune Status ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Severe Anemia ◽  
Subclinical Infection ◽  
Healthy Male ◽  
Respiratory Involvement ◽  
First Case ◽  
The Us

Babesiosis is a tick born zoonosis caused by red blood cell parasites of the genusBabesia. It is caused predominantly byB. microtiandB. divergens,microtibeing more common in the US. The parasites are transmitted byIxodestick to their host but infection can also spread by blood transfusion and perinatally. Clinical manifestations vary from subclinical infection to fulminating disease depending upon the immune status of the patient. About half of patients, hospitalized with babesiosis, develop complication with fatality rates of 6 to 9% which increase up to 21% among those with immunosuppression. A case of 58-year-old previously healthy man, infected byB.microti, was reported on 2000 who presented with severe disease characterized by severe anemia, DIC, and renal and respiratory failure. First case of overwhelming septic shock without respiratory involvement due to babesiosis in a healthy patient with an intact spleen was published in a case report on 2011. Since our patient here is an immunocompetent healthy male with intact spleen presenting with severe babesiosis requiring exchange transfusion, this presentation ofBabesiais rare and warrants further study.

scholarly journals Does Smoking and Alcohol Increase the Risk of COVID-19? A Review

2021 ◽  
Author(s):  
Ankit Mahajan ◽  
Ujwal Singh ◽  
Pankaj Kumar
Keyword(s):  
Respiratory Tract ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Unknown Origin ◽  
Capital City ◽  
World Health ◽  
Causative Organism ◽  
First Case ◽  
Tract Infections

AbstractThe first case of pneumonia of unknown origin was identified in Wuhan, the capital city of Hubei Province situated in the Republic of China. The pathogenic organism that has been identified as a causative organism is a novel enveloped RNA betacoronavirus, which has been designated as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This virus has been found to have a similar phylogeny to SARS-CoV. The novel coronavirus or COVID-19 can be symptomized through clinical manifestations like pyrexia or fever, cough, dyspnea/difficulty in breathing, myalgia/muscle pain, and constant fatigue. COVID-19 can be transmitted through respiratory tract secretions. It mainly results in respiratory tract infections and the development of severe pneumonia in infected patients. Severe disease may ultimately cause death due to progressive respiratory failure. The coronavirus disease 2019 or COVID-19 has been declared a public health emergency of international proportions by the World Health Organization (WHO). Thus, an analysis of cases might help in the identification of the disease's defining clinical characteristics, association with underlying lifestyle habits, and disease severity. This present article studied the probability of smoking and alcohol consumption in increasing the risk involved in increasing the severity of COVID-19 infection among affected subjects.

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