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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although chickenpox is a highly contagious disease affecting 90% of susceptible persons exposed, its morbidity and mortality in healthy patients is minimal. Treatment of chickenpox with oral acyclovir appears to decrease the number of pox lesions and shorten the duration of new lesion formation. Most importantly, children treated with acyclovir begin to feel better soon and had fewer systemic signs and symptoms of chickenpox (fever, fatigue, loss of appetite). However, the greatest mortality from chickenpox is seen in the immunocompromised patient, or in elderly patients with zoster (shingles) due to reactivation of latent varicella infection. Therefore, prevention of varicella is necessary to decrease mortality from the varicella-zoster virus. It is hopeful that the varicella vaccine will be licensed in the U.S. for routine immunization of healthy children within the next year. While its general use will not eliminate either chickenpox or zoster, there will be a considerable decrease in the morbidity and mortality caused by this agent as a result of routine immunization.
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PMID:Acyclovir in the treatment of chickenpox. 140 23

Six distinct human herpesviruses have been identified. They include Herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2), Cytomegalovirus (CMV), Varicella-zoster virus (VZV), Epstein-Barr virus and the recently described Human herpesvirus 6 (HHV-6). With the exception of HSV-2, the members of the family are ubiquitous and infect most of the human population in the first decade of life. HHV-6 possesses morphological and structural features characteristic of members from the herpesvirus family but it is both genetically and immunologically distinct from other members. The virus was first identified in 1986 by the group at the National Institutes of Health, Bethesda. Not until 1988 was the primary disease identified as that of a common childhood disease, exanthema subitum. There are independent reports on isolations of HHV-6 from the USA, Japan, U.K., Australia and Africa, demonstrating that the virus is a widespread agent. Its possible involvement in chronic fatigue disease and as a cofactor of development of AIDS are still subjects for discussion.
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PMID:Virological and clinical characteristics of human herpesvirus 6. 166 41

The chronic fatigue syndrome is a poorly defined symptoms complex characterized primarily by chronic or recurrent debilitating fatigue and various combinations of other symptoms, including psychological symptoms, sore throat, lymph node pain, headache, myalgia, arthralgias. Psychological disturbances, ranging from mild depression or anxiety to severe behavioral abnormalities, are always present. Chronic fatigue syndrome is the name that more accurately describes this symptom complex of unknown cause. A viral aetiology has long been hypothesized: many viruses are potential candidates, including any of the 23 Coxsackie A or 6 Coxsackie B viruses, herpes viruses, particularly Epstein-Barr virus and varicella. These studies, though interesting, remain unconvincing because of methodological flaws such as a poor case definition and inadequate control groups. This syndrome may represent an infection by a yet unidentified virus. It is more likely due to an abnormal immune response toward different intracellular pathogens. There is no treatment to ameliorate the chronic fatigue syndrome. Epidemiological studies are essential with explicit operational case definition before progress can be made in the management of this distressing disorder.
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PMID:[The chronic fatigue syndrome. A multifactorial approach and the treatment possibilities]. 207 78

Thirty-one late adolescents and adults with varicella were studied. Patients identified within 72 hours of varicella exanthem were offered open treatment with acyclovir (4 g/d), and those patients identified after 72 hours of exanthem were followed up but not treated. Twenty-two patients were treated with acyclovir. Nine patients were not treated. No severe complications occurred in any of the 31 patients. Minor complications, including prolonged fever, localized secondary infections, persistent cough, and prolonged fatigue were more frequent in the untreated group. If the acyclovir therapy was begun within the first 24 hours of varicella exanthem, then the rash and clinical illness were dramatically lessened. Treatment with oral acyclovir should be considered for varicella in adults who are identified within the first 24 hours of exanthem.
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PMID:Treatment of adult chickenpox with oral acyclovir. 222 91

A placebo-controlled study of varicella vaccine given either with or 6 weeks after measles-mumps-rubella (MMR) vaccine was undertaken in healthy children (mean age 16 months). A total of 101 varicella-zoster virus antibody-negative children completed the study. Serologic response to MMR vaccine was excellent (nearly 100%) and not significantly affected by the administration of varicella vaccine. Seroconversion in response to varicella vaccine was excellent and was not affected by MMR vaccine. No significant differences in fever or skin rashes between those receiving MMR vaccine with varicella vaccine or MMR vaccine with placebo were noted, but fever and skin rashes were more frequent after the first immunization (MMR with varicella vaccine or MMR vaccine with placebo) compared with the second (varicella vaccine or placebo injection). Symptoms of fatigue, irritability, and upper respiratory tract infections were more common after MMR vaccine was given regardless of whether it was given simultaneously with varicella vaccine or placebo injection.
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PMID:Placebo-controlled trial of varicella vaccine given with or after measles-mumps-rubella vaccine. 253 73

A benign, transient proliferation of atypical lymphocytes and a monoclonal rearrangement of the T-cell receptor beta (TRB) locus was found in a 60-year-old woman who presented with low-grade fever, anorexia and fatigue. A marked and transient atypical lymphocytosis (white blood cell count 90.5 x 10(9)/l) with CD8 surface antigen improved without specific treatment. Although tests for IgM antibodies to hepatitis A, varicella zoster, Epstein-Barr virus (EBV), and cytomegalovirus (CMV) were all negative, a monoclonal gene rearrangement of TRB locus was observed in the DNA of the proliferated atypical lymphocytes by Southern blotting. The clonal rearrangement and the atypical lymphocytes disappeared after 14 d, and the patient has remained well for 7 years. These results suggest that monoclonal proliferation of CD8 lymphocytes can occur based on a non-neoplastic aetiology.
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PMID:Transient appearance of CD3+CD8+ T lymphocytes with monoclonal gene rearrangement of T-cell receptor beta locus. 948 37

The most menacing complication of herpes zoster in immunocompetent elderly people is chronic pain or postherpetic neuralgia (PHN). The cardinal epidemiological feature of PHN is its striking relationship to aging. Among zoster patients over 60 years old, estimates of the occurrence of PHN, defined as pain 1 month after rash onset, vary from 27 to 68%. The pathogenesis of PHN is incompletely understood but seems to involve varicella-zoster virus (VZV)-induced damage of peripheral afferent neurons and resultant changes in central afferent neurons and efferent pain-modulating neurons. PHN improves over time in many elderly patients, but an unfortunate subset experience of debilitating pain lasts for years. They experience constant and/or intermittent spontaneous pain and stimulus-evoked pain such as allodynia or hyperpathia. The outcomes of this pain include fatigue, sleep disturbance, anorexia, depression, social withdrawal, impaired activities of daily living and profound lowering of quality of life. The management of PHN is hampered by two problems: (1) a uniformly effective treatment for PHN is not available (although tricyclic antidepressants, local or regional anaesthetics, capsaicin, opiates, anticonvulsants and physical therapies are sometimes useful); and (2) early antiviral therapy of zoster may be ineffective in preventing PHN, partly related to the fact that days of VZV replication and neuronal destruction have occurred by the time the patient reaches the doctor. A potential solution to the problem of PHN is the vaccination of elderly persons with the varicella vaccine to prevent or attenuate zoster or PHN.
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PMID:Postherpetic neuralgia in immunocompetent elderly people. 977 54

Here we report a case of acute cerebellitis, in which the patient developed right peripheral facial palsy during the recovery phase of cerebellar ataxia. A 67-year-old man developed truncal and limb ataxia following a fever, general fatigue and anorexia. He was diagnosed to have acute cerebellitis. While the ataxia symptoms were improving without any treatment, right peripheral facial nerve palsy developed and an MRI revealed an enhancement of the right facial nerve proximal to the geniculate ganglion. After treatment with acyclovir and corticosteroids, his facial nerve palsy and ataxia both gradually improved. There has been no previous report of an adult case who developed peripheral facial nerve palsy during the recovery phase of acute cerebellitis. This case indicates that a wide spectrum of neurological complications may develop in association with a varicella-zoster virus infection.
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PMID:[An adult case of peripheral facial nerve palsy following acute cerebellitis associated with high antibody titers against varicella-zoster virus]. 1034 52

We describe a case of unilateral IX, X and XI cranial and upper cervical nerve palsies involving zoster sine herpete (ZSH). A 63-year-old man experienced nausea, loss of appetite and general fatigue. On 4 days of illness, dysphagia, dysarthria and difficulty in elevation of his right arm appeared. Neurological examination showed the right curtain sign, a nasal voice and a decreased right gag reflex. He could hardly elevate his right arm laterally. Needle electromyography revealed positive sharp waves in his right trapezius muscle. Although no skin lesion was detected, anti-varicella-zoster virus antibodies were positive in both serum and cerebrospinal fluid. Acyclovir and a steroid were ineffective for these symptoms. Although case reports of unilateral IX, X and XI cranial nerve palsies with ZSH is very rare, ZSH should be kept in mind in the differential diagnosis of multiple cranial nerve palsies.
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PMID:[A case of zoster sine herpete with involvement of the unilateral IX, X and XI cranial and upper cervical nerves]. 1061 62

We report a case where acute varicella infection, chickenpox, mimics the findings of recurrent Hodgkin disease on F-18 FDG PET/CT. A 28-year-old man with a history of Hodgkin disease in remission had fatigue, pyrexia, and a raised ESR. His F-18 FDG PET/CT, performed to exclude lymphoma recurrence, demonstrated FDG-avid lymphadenopathy and increased FDG uptake in his spleen. A day later he developed the generalized rash of acute varicella infection. This was managed with valacyclovir. Repeat F-18 FDG PET/CT done 1 month later showed no evidence of FDG-avid disease. In this patient the stimulation of an immune response by the acute viral infection mimics recurrent lymphoma.
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PMID:Acute varicella infection mimics recurrent Hodgkin's disease on F-18 FDG PET/CT. 1788 70


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