Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a 41-year-old man with meningoencephalitis associated with herpes simplex virus type 1 (HSV-1). The patient developed fever, headache and dysuria followed by generalized convulsion and neck stiffness, and the CSF showed pleocytosis. The titers of enzyme-linked immunosorbent assay against HSV measured 6 days after onset showed a significant rise; IgG antibody 4.89 (<0.2) and IgM antibody 1.45 (<0.8) in CSF, IgG antibody 46.1 (<2.0) and IgM antibody 1.76 (<0.8) in the serum. The antibody index for IgG was 0.50, and that for IgM was 4.2. CFS neutralization test showed HSV-1 antibody of x16 and HSV-2 antibody of <x4. MRI showed atypical features: disseminated cortical lesions without massive hemispheric involvement. All of the cortical lesions were small and appeared to be located in the gray matter. The patient recovered with acyclovir. This report demonstrates that disseminated encephalitis can be a feature of acute HSV-1 infection.
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PMID:Herpes simplex virus type-1 meningoencephalitis showing disseminated cortical lesions. 1754 Dec 31

A 15-year-old girl was referred to our hospital due to fever, headache, and vomiting of 7 days duration and focal motor convulsion at the day of referral. Her clinical signs and cerebral imaging findings were found to be compatible with herpes simplex encephalitis. In spite of prompt acyclovir administration, her consciousness deteriorated gradually. Emergent cranial magnetic resonance imaging demonstrated a shift of midline intracranial structures. Decompressive surgery resulted in partial improvement in the shift of midline intracranial structures and potentially saved the patient's life. This case report stresses the importance of proper management of increased intracranial pressure in patients with herpes simplex encephalitis.
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PMID:A case of herpes simplex encephalitis revealed by decompressive craniectomy. 1791 51

A 33-year-old woman presented with stabbing perianal pain and intermittent headache and photophobia. Examination revealed atypical multiple perianal fissures with non-specific neurological findings. Polymerase chain reaction of the perianal swab and cerebrospinal fluid examination confirmed the diagnosis of perianal herpes simplex type 2 ulcer with herpes meningitis. This report emphasizes the importance of performing further investigations on patients with atypical anal fissures with or without systemic symptoms and signs to avoid misdiagnosis, inappropriate treatment and prolonged discomfort.
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PMID:Case report: herpes meningitis complicating genital herpes presenting as anal fissure. 1793 4

With the rapid progress in the development of highly active antiretroviral therapy (HAART), the observed patterns in human immunodeficiency virus (HIV) encephalitis has changed, allowing herpesvirus (HV) infection to be controlled. HAART was first administered to HIV patients in Cuba in 2001. Consequently with the aim of investigate the behavior of the HVs causing neurological disorders in this population in the post-HAART era, the authors perform a clinical evaluation by a multiplex nested polymerase chain reaction (PCR) assay for simultaneous detection of human HVs--herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV). The authors studied 241 samples of cerebrospinal fluid (CSF) received at the Sexually Transmitted Diseases Laboratory between 2001 and 2005 inclusive. Of the 241 CSF studied, 10.4% resulted positive for HV infections. Of these, 92% of patients were acquired immunodeficiency syndrome (AIDS) individuals at the C3 stage. CMV (44%), EBV (28%), and dual-HV (16%) infections were the most important agents identified. The principal clinical manifestations were fever, headache, vomiting, and focal abnormalities; the latter being associated with an increased risk of death. A statistically significant result was observed when central nervous system (CNS) disease evolution was compared between patients who were under HAART against those who were not, before they developed encephalitis. It was therefore concluded that it is more likely that HIV individuals receiving HAART have a better recovery of CNS infections than those who are not receiving it.
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PMID:The effect of highly active antiretroviral therapy on outcome of central nervous system herpesviruses infection in Cuban human immunodeficiency virus-infected individuals. 1799 29

A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus. Cerebrospinal fluid culture was negative for fungi and bacteria, including mycobacterium tuberculosis. Negative results for PCR and ELISA made herpes simplex virus encephalitis unlikely. We treated him empirically with aciclovir and cefpirome, conducting further tests because a HIV serological test was positive on admission. HIV RNA was 2.9 x 10(5) copies/ml in the blood. Western blot analysis demonstrated positive bands at gp160, p24, p55, and p68, but negative at gp120, p52, gp41, p40, p34, and p18. These results yielded a definitive diagnosis of acute primary HIV infection presenting as meningoencephalitis. His clinical condition improved over the next few days. Repeated MRI showed a new lesion in the pons on T2-weighted images. No MRI abnormality has reported previously in acute primary HIV infection with meningoencephalitis. High signal intensity in the bilateral globus pallidus and the pons in patients with meningoencephalitis may thus be a useful indicator for acute primary HIV infection.
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PMID:[Case of acute primary HIV infection with menigoencephalitis demonstrating high signal intensity of the bilateral globus pallidus in T2-weighted MRI]. 1801 20

A 24-year-old immune-competent woman was admitted to hospital with a three-day history of fever and headache. On examination bilateral facial nerve palsy, lumbosacral radicular pain, reduced sacral sensibility and urinary retention were found. Open perianal lesions were suspect for genital herpes. The symptoms were compatible with a meningoradiculitis including a sacral polyradiculitis. On testing, cerebrospinal fluid was found to be abnormal with a lymphocytic cell reaction. Polymerase chain reaction (PCR) of cerebrospinal fluid and of the perianal lesions was positive for herpes simplex virus type 2 (HSV-2). An MRI scan showed colouration of part of the cauda equina. The patient was treated by intravenous injections of acyclovir 10 mg/kg t.i.d. for 21 days, after which she completely recovered. HSV-2 infection of the nervous system can cause lymphocytic, and sometimes recurrent meningitis as well as sacral polyradiculitis. It may also occur without any symptomatic genital herpes infection. A positive result from a PCR test of the cerebrospinal fluid confirms this diagnosis. Treatment with acyclovir should be started as soon as possible.
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PMID:[Meningoradiculitis caused by herpes simplex virus type 2]. 1801 19

A 37-year-old woman developed memory disturbance and seizures preceded by headache and high fever. Physical examination revealed persistent high fever, confusion, neck stiffness, anterograde and retrograde amnesia and disorientation. CSF showed pleocytosis and normal glucose level, and negative herpes simplex virus DNA on PCR. The fluid attenuated inversion recovery (FLAIR) MRI of the brain demonstrated nearly symmetric high signal intensity areas in the bilateral mesial temporal lobes. The tentative clinical diagnosis was non-herpetic acute limbic encephalitis (NHALE), and administration of methylprednisolone improved her conditions. Laboratory tests revealed mild hypothyroidism with high titers of serum antibodies against TPO and thyroglobulin, consistent with Hashimoto's disease. In addition, antibodies against amino terminal of alpha-enolase in the serum and those against glutamate receptor (GluR) epsilon2 in the serum and CSF were positive. A final diagnosis of Hashimoto's encephalopathy associated with GluRepsilon2 antibody was made. The present case suggests that NHALE-like clinical manifestation can be produced by autoimmune-mediated encephalopathies.
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PMID:[Non-herpetic acute limbic encephalitis-like manifestation in a case of Hashimoto's encephalopathy with positive autoantibodies against ionotropic glutamate receptor epsilon2]. 1809 94

A 46 years, nondiabetic, nonhypertensive woman presented with headache, vomiting, low grade intermittent fever, behavioral abnormality and seizures for last three months. Clinically she had meningism with bilateral papilloedema. Based on CSF analysis, normal CT scan of brain and suspicious lesion in X-ray chest, she was put on anti-tuberculosis therapy. As the patient further deteriorated clinically, MRI of brain was carried out and revealed bilateral increased signal intensities in both medial temporal lobes in T2 and flair sequences. Inj. acyclovir was added considering the diagnosis of herpes simplex encephalitis. In spite of receiving treatment patient gradually became more drowsy and repeat X-ray chest with CT guided FNAC showed picture of adenocarcinoma of lung. So finally, we concluded it to be a case of limbic encephalitis.
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PMID:Limbic encephalitis--an uncommon presentation of systemic malignancy. 1817 29

A woman, aged 27 years, developed acute headache and fever followed by tremor, rigidity, and bradykinesia. Masked face, drooling saliva, monotonous voice, and dysphagia were observed. She was totally bedridden during the worst period because of marked generalized rigidity and bradykinesia. There was no neurological disturbance other than parkinsonism. Several herpetic vesicles were noticed at the left angle of her mouth. The cerebrospinal fluid revealed a mononuclear pleocytosis with a normal concentration of sugar and protein. The antibody test for Type I herpes simplex virus was positive in the serum but negative in the cerebrospinal fluid. Brain CT and EEG were normal. However, MRI study showed markedly increased signals in the bilateral substantia nigra on T2-weighted, proton density, and in gradient recall acquisition imagings. Those abnormal findings had almost disappeared in a follow-up MRI study 2 months later. Her parkinsonian symptoms were substantially resolved by the time. However, PET scans, performed 8 months later, disclosed: (1) mild reduction of fluorodopa uptake; and (2) increased raclopride binding, predominantly in the putamen. These findings suggest a subclinical nigrostriatal dopaminergic deficit and a relative excess of the D2 receptors, with a pattern similar to that found in typical idiopathic parkinsonism.
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PMID:Isolated involvement of substantia nigra in acute transient parkinsonism: MRI and PET observations. 1859 Oct 4

Pierre Mollaret is mainly known for his contributions to infectious diseases and their prevention. He also described benign, recurrent endothelio-leukocytic meningitis in three patients who had short-lived recurrent attacks of fever, headache and vomiting caused by sterile meningitis, with 'fantomes cellulaires' (cell ghosts) in the cerebrospinal fluid. Identical symptoms are caused by Herpes simplex virus-2 and other viruses. The term Mollaret's meningitis should be restricted to idiopathic recurrent aseptic meningitis. This paper briefly outlines the syndrome and its discoverer.
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PMID:Mollaret's meningitis. 1883 46


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