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Query: UMLS:C0018681 (
headache
)
56,091
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We reported a 59-year-old woman with four episodes of recurrent self-limited aseptic meningitis. Her episodes had resolved in 14-20 days without residural and all were marked clinically by acute
headache
, back pain, and nausea with fever. No concurrent systemic or genital symptoms or signs were present. CSF analysis performed on the third day of her fourth episode of recurrent meningitis showed the DNA of
herpes simplex
virus type 2 by means of the polymerase chain reaction method. Acyclovir therapy may be useful in a further possible occurrence of meningitis.
...
PMID:[A case of recurrent aseptic meningitis (Mollaret meningitis) with back pain in which was detected the DNA of herpes simplex virus type 2 in cerebrospinal fluid]. 1235 47
Adrenal insufficiency combined with gastric ulcer due to
herpes simplex
virus (HSV) infection is a very unusual condition. A 75-year-old woman suffered from a 4-day history of poor appetite, constipation, dysuria, severe
headache
, generalized pain and malaise. Hyponatremia was noted. Escherichia coli infection was identified from urine culture. Poor pituitary-adrenal axis response to hyponatremia and infection, as well as a history of intermittent treatment with steroids, led to a diagnosis of iatrogenic tertiary adrenal insufficiency. During hospitalization, the patient passed tarry stools. In addition to an antral ulcer, panendoscopy revealed an ulcer in the gastric cardia with a clean base and irregular margins. Biopsy of the cardia demonstrated multinucleated giant cells in the stratified squamous epithelium. Polymerase chain reaction studies confirmed HSV type 1 infection. In patients suffering from gastric cardia ulcer, the possibility of herpes infection must be considered, especially when complicated by steroid treatment or misuse. Because herpes infection in the squamous epithelium is self-limiting, practitioners should be aware of it, so that overtreatment can be avoided.
...
PMID:Adrenal insufficiency combined with gastric cardia ulcer due to herpes simplex virus type 1 infection. 1251 48
The objective of the paper was compare the effects and tolerability of combined therapy of multiple intravenous infusions of anti-tumour necrosis factor-alfa (TNF-alfa) monoclonal antibody (Remicade) with methotrexate versus treatment with sodium aurothiomalate and intramuscular depot methylprednisolone in rheumatoid arthritis (RA). We investigate also the interval necessary to obtain the improvement in both treatment groups. 36 patients commencing intramuscular sodium aurothiomalate therapy with intramuscular depot methylprednisolone acetate at weeks 0, 4, 8 and 12 in addition to chrysotherapy were compared in retrospective analysis with 32 patients starting with multiple intravenous infusions of infliximab, anti-TNF-alfa monoclonal antibody (Remicade) and methotrexate at a stable dose. Patients were assessed by composite clinical score (DAS 28) and C-reactive protein during 22 weeks of therapy. At week 2 and 6 a significantly greater percentage of infliximab-treated than gold-treated RA patients achieved improvement in each clinical measurement of disease activity. At 22 week of treatment moderate and good response according to EULAR criteria was achieved in 91% of infliximab-treated patients and 58% gold treated patients (p < 0.001). Adverse events were more frequently observed in infliximab-treated patients, but only gold-treated patients discontinued treatment because adverse events (2 patients due to proteinuria, 2 patients due to mucocutaneous changes and one patient due to leucopenia). The higher percentage of adverse events in infliximab-treated patients was caused mainly by the occurrence of infusion reactions (23 reactions out of 160 infusions); most of them were mild (somnolentia and
headache
) and transient. Viral infections (including
herpes simplex
and zoster) were more common in patients treated with infliximab and methotrexate. Combination therapy of infliximab and methotrexate is more effective in reducing clinical and biochemical disease activity than gold with methylprednisolone treatment in RA patients during 22 weeks of treatment, especially in the first 6 weeks.
...
PMID:[Analysis of efficacy and safety of multiple intravenous infusion of anti-tumor necrosis factor-alpha monoclonal antibody (Remicade) combined with methotrexate compared with sodium aurothiomalate and intramuscular depot methylprednisolone in rheumatoid arthritis]. 1268 46
Mollaret's meningitis (MM) is a rare disease of benign nature characterized by recurrent episodes of aseptic meningitis. Cerebrospinal fluid (CSF) examination remains the sole diagnostic modality. Eighteen CSF samples from 14 patients were studied along with the clinical data. Specimens were prepared by cytocentrifugation and Millipore filtration and were stained with Diff-Quik and Papanicolaou stains. Eight patients were men and six were women, with an age range of 17-74 yr (mean age 37 yr). Most common clinical presentation was recurrent episodes of
headaches
and photophobia followed by a sustained mild fever lasting 5-7 days. The CSF showed markedly increased cellularity with pleocytosis. The differential count showed predominant monocytosis ranging from 84% to 100% (mean 96). In our series, two patients had
herpes simplex
virus type 2 (HSV-2) DNA detected by polymerase chain reaction (PCR) in the CSF. The monocytes were seen predominantly singly, but three cases showed a strong tendency to aggregate in small groups. Phenotypically, these cells had bean-shaped bilobed nuclei as well as multiple deep nuclear clefts depicting the so-called "footprint" appearance. In four cases, multiple blunt-tipped cytoplasmic pseudopods were noted. Degenerated monocytes with the appearance of the so-called "ghost cells" were noted in one-half of the cases. Background cells were mostly small mature lymphocytes; however, one-half of cases showed a significant amount of plasma cells and/or polymorphonuclear leukocytes (PMNs). Lysed blood with hemosiderin-laden macrophages and numerous leptomeningeal cells were seen in two cases. CSF examination of MM presents a spectrum of cytomorphologic features. When interpreted in light of the appropriate clinical setting. the latter, although nonspecific, provides an accurate diagnosis. The differential diagnosis includes various degenerative, inflammatory/infectious, and lymphoproliferative disorders of the central nervous system.
...
PMID:Mollaret's meningitis: cytopathologic analysis of fourteen cases. 1272 16
Forty-three consecutive cases of acute aseptic meningitis (AAM) presenting within a 24-months period were retrospectively analysed with respect to clinical symptomatology, cerebrospinal fluid (CSF) findings, clinical course, treatment and outcome. Nineteen of the 43 AAM cases (44%) were caused by enterovirus, one by HIV (2%), two by Varicella zoster virus (5%), three due to
herpes simplex
virus I (7%), two due to
herpes simplex
virus II (5%), one due to Central European encephalitis virus (2%), and in 15 patients (35%) the aetiology of AAM remained unknown.
Headache
(100%) and fever (93%) were the presenting symptoms in the majority of cases. Signs of preceding infection were predominantly gastrointestinal in the enterovirus subgroup, but were inconsistently observed in the other subgroups. CSF findings at the first lumbar tap on admission generally revealed lymphomonocytic pleocytosis of less than 500 cells per micro l, mild to moderately elevated protein and normal lactate and glucose levels. Initial therapy consisted of an empirical antiviral and antibiotic regimen until a serological diagnosis was available. Acyclovir, effective only in herpes family viruses, was initially administered to all AAM cases. Effective therapy for other viral pathogens are not broadly available and treating AAM of unknown aetiology imposes a particular problem. The average hospitalization time ranged from 16 to 31 days. Patients were either discharged home (72%) or transferred to a rehabilitation centre (28%). The outcome was good (40%) to fair (51%) in the majority of cases.
...
PMID:A retrospective clinical, laboratory and outcome analysis in 43 cases of acute aseptic meningitis. 1275 1
We describe a case of chronic atypical
herpes simplex
type 2 encephalitis in an immunocompromised 68 year old man presenting with
headache
and cognitive changes without focal neurological or MRI findings. To our knowledge this is the first described case of
herpes simplex
encephalitis associated with normal MRI brain imaging and non-focal neurological examination. This further expands the range of clinical presentations that may be associated with
herpes simplex
encephalitis and emphasises the value of PCR for
herpes simplex
virus in the investigation of encephalitis regardless of imaging findings.
...
PMID:Atypical herpes type 2 encephalitis associated with normal MRI imaging. 1281 Jul 97
We report two cases of non-herpetic acute limbic encephalitis (NHALE) which showed elevation of interleukin (IL)-6 in the cerebrospinal fluid (CSF). [Case 1] The patient was a 25-year-old woman who was admitted to another hospital because of fever and severe
headache
, following common cold. After the admission, she developed severe disturbance of consciousness and suffered from generalized convulsions, and was then transferred to our hospital. The CSF examination revealed neither pleocytosis nor elevation of total protein. Her consciousness improved by intravenous administration of high-dose methylprednisolone, but mild retrograde amnesia and symptomatic epilepsy remained as sequelae. [Case 2] The patient was a 58-year-old man who was admitted to our hospital because of fever, severe
headache
, and mild disturbance of consciousness, following common cold. After the admission, he exhibited marked psychiatric symptoms and severe amnestic syndrome. The CSF examination revealed mild lymphocytic pleocytosis and mild elevation of total protein. His clinical symptoms improved markedly by intravenous administration of high-dose methylprednisolone, but mild retrograde amnesia and personality changes remained. Cranial MRI showed reversible high signal intensity lesions in bilateral hippocampi and amygdaloid bodies on diffusion weighted images (DWI) in both cases. No laboratory findings suggesting
herpes simplex
virus infection or malignancy were detected in either case. In the CSF analysis of cytokines including IL-1 beta, IL-2, IL-6, IL-10, tumor necrosis factor alpha, and interferony gamma, only IL-6 was elevated in both cases. We recognized four clinical features in both cases as follows: 1. the episode of preceding infection such as common cold, 2. appearance of reversible high signal intensity lesions in bilateral hippocampi and amygdaloid bodies on DWI, 3. elevation of only IL-6 in CSF, and 4. marked neurological improvement by intravenous administration of high-dose methylprednisolone. We speculate that the immune reaction of the host might play some significant roles in the pathogenesis of NHALE, based on these four clinical features.
...
PMID:[The analysis of cytokines in cerebrospinal fluid (CSF) in two cases of non-herpetic acute limbic encephalitis (NHALE)]. 1288 25
Encephalitis is an unusual manifestation of viral infections. Encephalitis manifests with fever,
headache
and an altered level of consciousness. To identify an etiologic diagnosis, epidemiologic data (season, prevalent diseases, travel, exposure and animal contacts) may be helpful, whereas clinical findings mostly are nonspecific. The cerebrospinal fluid analysis shows a moderate pleocytosis with a slightly increased protein concentration. With PCR, the ability to diagnose CNS viral infections has improved, particularly for
herpes simplex
and enteroviral infections. Effective therapy is available only for a limited number of viral infections. Some cases of encephalitis can be reliably prevented by vaccination (measles, mumps, TBE, rabies). Tick-borne encephalitis (TBE), which is of particular interest in Switzerland, is described in detail.
...
PMID:[Viral encephalitis, early summer meningoencephalitis]. 1461 Sep 3
Herpes simplex encephalitis is a rare complication of Herpes virus infections. Innate immune mechanisms are the first line of defence encountered by invading infectious agents. A 41-year-old man was admitted to the neurology department with the complaints of fever,
headache
, vertigo, tinnitus and ataxia. His first brain Magnetic Resonance Imagine showed nodular lesions in the medulla oblongata and the second showed a new left occipital lobe lesion in addition. In sera,
Herpes Simplex
Virus IgG and M values were positive and liver enzymes were found to be elevated. His diagnosis was Herpes encephalitis with liver involvement. CD19, CD20, CD21, CD22, CD35 receptors were found to be diminished. In this case we want to address that one of the causes of Wallenberg's lateral medullary syndrome can be
Herpes simplex
virus-1 and probable immune system deficiency can be researched.
...
PMID:An atypic herpes encephalitis with Wallenberg's lateral medullary syndrome and CD receptors deficiency. 1516 83
Presented here is the case of an immunocompetent pregnant woman with probable cytomegalovirus encephalitis. The clinical picture was characterized by diffuse
headache
, drowsiness and the development of an acute confused state. Diagnosis was based on the documentation of recent cytomegalovirus seroconversion with low avidity for the immunoglobulin G class antibodies. Initially, the diagnosis of encephalitis was challenging due to the subtle findings in cerebrospinal fluid and the normal electroencephalograph results. However, repeated tests revealed findings compatible with the diagnosis of encephalitis. Due to the suspicion of
herpes simplex
encephalitis the patient was treated with acyclovir. Within a few days rapid resolution of the fever and complete recovery were observed. Cytomegalovirus encephalitis should be considered early in the evaluation of pregnant women if appropriate clinical symptoms are present.
...
PMID:Cytomegalovirus encephalitis in an immunocompetent pregnant woman. 1522 16
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