Document Type : Original Research
Authors
- Farideh Ebrahimi Taj 1
- Samileh Noorbakhsh 1
- Hamid Reza Monavari 2
- Azardokht Tabatabaei 3
- Masomeh Bakhshyeh 3
1 Dept. of Infectious Disease, Research Center of Pediatric Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
2 Dept. of Virology, Research Center of Pediatric Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
3 Dept. of Microbiology, Research Center of Pediatric Infectious Diseases, Tehran University of Medical Sciences
Abstract
Background and Objectives: Meningoencephalitis in Iranian children is frequent, but encephalitis is rare .The frequency of HHV-6 and HHV-7 in central nervous system diseases of our children is unclear. The aim of this study was searching the DNA-s of HHV-6 & HHV-7 in CSF samples of children with meningoencephalitis
Materials and Methods: A cross sectional study (2007-2009) was done in Pediatric Ward in Rasoul Hospital, Tehran Iran. Totally, 150 CSF samples obtained from children (1-180 months) with meningoencephalitis. Conventional and BACTEC Ped Plus medium, latex agglutination tests were used for ruling out the bacterial causes. We searched the DNA-s of HHV-6 & HHV-6 quantitatively by Real time - PCR in 150 CSF samples obtained from children with meningoencephalitis.
Results: 60.7 % of cases were male. Fever was reported (>38.5) in 74%; irritability in 70%; Convulsion was seen in 53% of cases. Herpes virus was detected in 12% (18/150) of cases. Both HHV-6 & HHV-7 were found in 6% of all cases. HHV-6 DNA was detected in 4.7% (6) and HHV-7 DNA was detected in 2 cases (1.4%) without any correlation to age, sex and clinical signs. HHV-6 was slightly more frequent than HHV-7.
Conclusion: Our data indicate that herpes viruses are not uncommon causes in children with meningoencephalitis. The incidence was lower than other references.
Keywords
- Shameem S, Vinod Kumar CS, Neelagund YF. Bacterial meningitis: rapid diagnosis and microbial profile: a multicentered study. J Commun Dis 2008;40(2):111-20.
- Negrini B, Kelleher KJ, Wald ER. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics 2000;105(2):316-9.
- Behrman RE, Kliegman RM, Jenson HB. Text Book of Pediatrics. 17th ed. Philadelphia: WB Saunders; 2004.
- Behrman RE, Kliegman RM, Jenson HB. Text Book of Pediatrics. 16th ed. Philadelphia: WB Saunders; 2000.
- Tsang ML, Munz C. Cytolytic T lymphocytes from HLA-B8+ donors frequently recognize the Hodgkin's lymphoma associated latent membrane protein 2 of Epstein Barr virus. Herpesviridae 2011 Feb 11;2(1):4.
- Ward KN, Andrews NJ, Verity CM, Miller E, Ross EM. Human herpesviruses-6 and -7 each cause significant neurological morbidity in Britain and Ireland. Arch Dis Child 2005;90(6):619-23.
- Tyler KL. Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's. Herpes 2004 Jun;11 Suppl 2:57A-64A.:57A-64A.
- Schultze D, Weder B, Cassinotti P, Vitek L, Krausse K, Fierz W. Diagnostic significance of intrathecally produced herpes simplex and varizella-zoster virus-specific antibodies in central nervous system infections. Swiss Med Wkly 2004 Nov 27;134(47-48):700-4.
- Hall CB, Caserta MT, Schnabel KC, McDermott MP, Lofthus GK, Carnahan JA, et al. Characteristics and acquisition of human herpesvirus (HHV) 7 infections in relation to infection with HHV-6. J Infect Dis 2006 Apr 15;193(8):1063-9.
- Harrison NA, MacDonald BK, Scott G, Kapoor R. Atypical herpes type 2 encephalitis associated with normal MRI imaging. J Neurol Neurosurg Psychiatry 2003;74(7):974-6.
- De T, X, Heron B, Lebon P, Ponsot G, Rozenberg F. Limits of early diagnosis of herpes simplex encephalitis in children: a retrospective study of 38 cases. Clin Infect Dis 2003 May 15;36(10):1335-9.
- (Clinical, radiologic, pathological features and diagnosis of 14 cases with interstitial lung disease in children.). Zhonghua Er Ke Za Zhi 2011;49(2):92-7.
- Pritz T, Memphill R, Talavera F. Herpes Simplex Encephalitis. Medicine 2002 Aug 1;1-11.
- Yao K, Honarmand S, Espinosa A, Akhyani N, Glaser C, Jacobson S. Detection of human herpesvirus-6 in cerebrospinal fluid of patients with encephalitis. Ann Neurol 2009;65(3):257-67.
- Caserta MT, Hall CB, Schnabel K, McIntyre K, Long C, Costanzo M, et al. Neuroinvasion and persistence of human herpesvirus 6 in children. J Infect Dis 1994;170(6):1586-9.
- Pohl-Koppe A, Blay M, Jager G, Weiss M. Human herpes virus type 7 DNA in the cerebrospinal fluid of children with central nervous system diseases. Eur J Pediatr 2001;160(6):351-8.
- Yoshikawa T, Ihira M, Suzuki K, Suga S, Matsubara T, Furukawa S, et al. Invasion by human herpesvirus 6 and human herpesvirus 7 of the central nervous system in patients with neurological signs and symptoms. Arch Dis Child 2000;83(2):170-1.
- Tabatabaei A, Aghaei F. Herpes Simplex Frequency in CSF of Encephlaitic Patients by PCR. Iran Inf and Trop Dis J 1999;14(10):19-26.
- Noorbakhsh S, Tonekaboni H, Rimaz S, Aghahosseini F. Detection the Ferequency of Herpes Virus Infection in Aseptic Meningitis in Children Admitted in Rasool Akram & Mofid Hospital. J Iran uni Med sci 2004;27(8):641-8.
- Expert working group on HHV-6 and 7 laboratory diagnosis and testing. Can Commun Dis Rep 2000 Sep;26 Suppl 4:i-iv, 1-27, i-iv passim.:i-27, i.
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