A Pregnant Woman With Influenza A Encephalopathy in Whom Influenza A/Hong Kong Virus (H3) Was Isolated From Cerebrospinal Fluid

Hakoda, Shigeru

doi:10.1001/archinte.160.7.1041

Cited by 23 publications

(11 citation statements)

References 2 publications

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“…Reports in recent years from Japan, Canada, and the United States have described significant mortality and rates of neurological sequelae associated with neurological complications of influenza, occurring primarily in children under the age of 15 years 4–8 . Other reports have communicated isolated cases of CNS complications in adults 9–11 . Our series is unusual in that three of the six are adults and only one was under 15 years.…”

Section: Discussionmentioning

confidence: 62%

Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series

Noriega

Verdugo

Araos

et al. 2010

Influenza Resp Viruses

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Please cite this paper as: Noriega et al. (2010) Pandemic influenza a (H1N1) 2009 with neurological manifestations, a case series. Influenza and Other Respiratory Viruses 4(3), 117–120. Objectives Describe a series of atypical presentations of pandemic influenza A (H1N1) 2009. Methods Description of case series using hospital records. Results Six patients aged 1 to 65 years with confirmed pandemic influenza A (H1N1) 2009 infection presented with neurological complications within 2 to 5 days after the first signs of influenza‐like illness. All six were admitted with seizures or altered mental status. No abnormalities were found in brain scans or cerebral spinal fluid studies of any of the six. All were discharged without sequelae within days of admission. Conclusions This is only the second report of pandemic influenza presenting with neurological manifestations. Clinicians caring for patients when pandemic influenza is prevalent in their communities should maintain a high level of awareness of the potential atypical presentations with which this disease can appear.

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Section: Discussionmentioning

confidence: 62%

Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series

Noriega

Verdugo

Araos

et al. 2010

Influenza Resp Viruses

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“…However, influenza virus was isolated from blood, [5][6][7][8] as well as extrapulmonary regions such as lymph node, spleen, liver, kidney, adrenal glands, meninges, 7,[9][10][11] and cerebrospinal fluid. 12,13) These findings substantiate the occurrence of viremia in influenza virus infection and the extrapulmonary dissemination of the virus. Furthermore, influenza virus has been isolated from fetal heart, 10) placenta 14) and amniotic fluid, 10,15) suggesting the occurrence of fetal, placental and amniotic fluid infections with this virus.…”

mentioning

confidence: 53%

Apoptosis in Cultured Human Fetal Membrane Cells Infected with Influenza Virus.

Uchide

Ohyama

Bessho³

et al. 2002

Biological & Pharmaceutical Bulletin

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When a virus encounters a susceptible cell, the virus enters it to initiate cytocidal, persistent, latent or abortive cell infection. The influenza virus induces cytocidal infection accompanied by virus production and cell death in several types of cultures such as HeLa and Madin-Darby canine kidney (MDCK) cell lines and human peripheral blood monocytes in vitro, all of which die through the mechanism of apoptosis. 1-4)The human influenza virus usually infects the human respiratory organs. However, influenza virus was isolated from blood, [5][6][7][8] as well as extrapulmonary regions such as lymph node, spleen, liver, kidney, adrenal glands, meninges, 7,[9][10][11] and cerebrospinal fluid.12,13) These findings substantiate the occurrence of viremia in influenza virus infection and the extrapulmonary dissemination of the virus. Furthermore, influenza virus has been isolated from fetal heart, 10) placenta 14) and amniotic fluid, 10,15) suggesting the occurrence of fetal, placental and amniotic fluid infections with this virus.The influenza virus has not so far been isolated from the fetal membranes of a mother who died of influenza virus infection to our knowledge. However, the virus has been isolated from the placenta and amniotic fluid. 14,15) Additionally, organ cultures of human placenta allow influenza virus replication.16) The influenza virus may spread from the placenta to fetal membranes because they are continuous with the placenta. Furthermore, since amniotic fluid fills amniotic cavity formed by fetal membranes, influenza virus in amniotic fluid may influence the membrane cells. However, little is understood about the influence of influenza virus on human fetal membrane cells.We investigated the relationship between the influenza virus and cultured human fetal membrane cells by studying virus production and the apoptotic death of these cells in vitro. We found that the influenza virus induced cytocidal infection in chorion cells, persistent infection accompanied by virus production and cell survival in amnion cells, and that influenza virus-infected chorion cells became degraded through the apoptotic pathway. The present study demonstrates that the host cells make the choice to commit to degradation through this pathway. MATERIALS AND METHODSChemicals Ribavirin (1-b-D-ribofuranosyl-1,2,4-triazole-3-carboxamide) was purchased from Sigma (MO, U.S.A.).Influenza Virus Propagation and Plaque-Forming Assay Influenza virus type A (PR/8/34, H1N1) was propagated in the allantoic cavity of 11-d-old embryonal chicken eggs for 48 to 72 h at 35°C as described.2) Plaque-forming capacity was assayed on confluent monolayers of MDCK (NBL-2) cells (Human Science Research Resources Bank, Japan) as described.4) The chorioallantoic fluid contained 8ϫ10 8 plaque-forming units (PFU)/ml and the hemagglutination titer using human erythrocytes was 1 : 256. Cell Cultures and Virus Infection Human fetal membranes were prepared aseptically from placentas obtained by cesarean section in the month of normal parturition. Primary cult...

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“…2. In total, 44 cases of IAE in adults were identified from 31 reports (Ak et al , 2012; Akins et al , 2010; Alakare et al , 2010; Bartynski et al , 2009; Bulakbasi et al , 2006; Chen et al , 2010; Cheng et al , 2011; Cunha et al , 2012; Fukami et al , 2005; Gadoth et al , 2010; Goenka et al , 2014; Gonzalez & Brust, 2009; Hakoda & Nakatani, 2000; Hawkins et al , 1987; Hjalmarsson et al , 2009; Iijima et al , 2002; Ishii et al , 2015; Ito et al , 2011; Jeganathan et al , 2013; Khosla et al , 2011; Kimura et al , 2008; Lee et al , 2010; Salonen et al , 1997; Santini et al , 2012; Simon et al , 2013; Steinberg et al , 1972; Steininger et al , 2003; Tsai et al , 2011; Wang et al , 2011, 2015; Yamashita et al , 2008). The cases are summarized in the supplementary material.…”

Section: Resultsmentioning

confidence: 99%

Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis

et al. 2016

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Background: Acute influenza-associated encephalopathy/encephalitis (IAE) in adults is a rare but well-known complication of influenza virus infection. The diagnosis is difficult to make due to the absence of distinctive clinical symptoms and validated diagnostic criteria. We present an illustrative case and a case review on acute IAE in adults.Methods: We performed a Medline search of the English literature using the terms influenz*, encephal* and adult, and constructed a database of detailed descriptions of patients with influenza virus infection with influenza-like symptoms at the onset of neurological symptoms.Results: A total of 44 patients were included. Confusion and seizures were the most prevalent neurological symptoms, present in 12 (27 %) and 10 (23 %) patients, respectively. Magnetic resonance imaging (MRI) was performed in 21 patients and anomalies were found in 13 (62 %), with lesions located throughout the brain. Influenza virus RNA was detected in cerebrospinal fluid (CSF) in 5 (16 %) of 32 patients. Eight (18 %) of the forty-four patients died. The benefits of antiviral and immunomodulatory therapy have not been well studied.Discussion: Our results show that many different neurological symptoms can be present in patients with acute onset IAE. Therefore, the diagnosis should be considered in patients with fever and neurological symptoms, especially during the influenza season. Laboratory diagnosis consists of demonstration of influenza virus RNA in brain tissue, CSF or respiratory samples, and demonstration of intrathecal antibody production against influenza virus. The presence of brain lesions in MRI and influenza virus in CSF appear to be of prognostic value.

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A Pregnant Woman With Influenza A Encephalopathy in Whom Influenza A/Hong Kong Virus (H3) Was Isolated From Cerebrospinal Fluid

Cited by 23 publications

References 2 publications

Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series

Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series

Apoptosis in Cultured Human Fetal Membrane Cells Infected with Influenza Virus.

Acute influenza virus-associated encephalitis and encephalopathy in adults: a challenging diagnosis

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