An unusual case of acute transverse myelitis caused by HSV-1 infection

Figueroa, Danisha; Isache, Carmen; Sands, Michael

doi:10.1016/j.idcr.2016.05.007

Cited by 11 publications

(9 citation statements)

References 4 publications

(8 reference statements)

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“…In mice infected with PrV-ΔUL21/US3Δkin, myelitis as well as zosteriform alopecic skin lesions which are typical pathologic hallmarks of infection primarily with VZV [10,99] were observed. In VZV, segmental rash occurs during virus reactivation in dorsal root ganglia, which are associated with a corresponding dermatome, but, in contrast to our finding, carry viral antigen [10,100].…”

Section: Plos Pathogensmentioning

confidence: 99%

An improved animal model for herpesvirus encephalitis in humans

et al. 2020

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Herpesviral encephalitis caused by Herpes Simplex Virus 1 (HSV-1) is one of the most devastating diseases in humans. Patients present with fever, mental status changes or seizures and when untreated, sequelae can be fatal. Herpes Simplex Encephalitis (HSE) is characterized by mainly unilateral necrotizing inflammation effacing the frontal and mesiotemporal lobes with rare involvement of the brainstem. HSV-1 is hypothesized to invade the CNS via the trigeminal or olfactory nerve, but viral tropism and the exact route of infection remain unclear. Several mouse models for HSE have been developed, but they mimic natural infection only inadequately. The porcine alphaherpesvirus Pseudorabies virus (PrV) is closely related to HSV-1 and Varicella Zoster Virus (VZV). While pigs can control productive infection, it is lethal in other susceptible animals associated with severe pruritus leading to automutilation. Here, we describe the first mutant PrV establishing productive infection in mice that the animals are able to control. After intranasal inoculation with a PrV mutant lacking tegument protein pUL21 and pUS3 kinase activity (PrV-ΔUL21/US3Δkin), nearly all mice survived despite extensive infection of the central nervous system. Neuroinvasion mainly occurred along the trigeminal pathway. Whereas trigeminal first and second order neurons and autonomic ganglia were positive early after intranasal infection, PrV-specific antigen was mainly detectable in the frontal, mesiotemporal and parietal lobes at later times, accompanied by a long lasting lymphohistiocytic meningoencephalitis. Despite this extensive infection, mice showed only mild to moderate clinical signs, developed alopecic skin lesions, or remained asymptomatic. Interestingly, most mice exhibited abnormalities in behavior and activity levels including slow movements, akinesia and stargazing. In summary, clinical signs, distribution of viral antigen and inflammatory pattern show striking analogies to human encephalitis caused by HSV-1 or VZV not observed in other animal models of disease.

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Section: Plos Pathogensmentioning

confidence: 99%

An improved animal model for herpesvirus encephalitis in humans

et al. 2020

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“…There are reports that HSV causes TM. [5][6][7] There have been two reported TM cases with herpetic genital lesion. 6 We believed that HSV might be the cause of TM.…”

Section: Discussionmentioning

confidence: 99%

Acute urinary retention and progressive paraplegia with genital infection: A case report of transverse myelitis

Kim

Lee²

2020

Hong Kong j. emerg. med.

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Introduction: Transverse myelitis (TM) is a rare inflammatory disorder involving single or multiple spinal segments. There are various Infectious and parainfectious causes. Case presentation: We report the case of 29-year-old female who presented to an emergency department with acute urinary retention, progressive headache and sensory and motor deficits with a genital infection. Cerebrospinal fluid (CSF) analysis revealed WBC 75/μL, protein 96 (15-40 mg/dL), and VZV IgG positive. The magnetic resonance image (MRI) of the spine revealed acute transverse myelitis of C4, C6/C7 and T2-T3, T4-T7. She was treated with steroid pulse therapy, intravenous antiviral therapy, antibiotics, and rehabilitation. Urinary symptoms resolved in six days and her motor deficit resolved. She had mild numbness in the thigh area 2 months later. Discussion: Identification of the causes and diagnosis of TM are challenging because there are variable clinical signs and numerous potential pathogens. Conclusion: It is essential to diagnosis TM in the early and timely phase, careful, detailed history and thorough physical examination by emergency physicians.

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“…25,26 The reports suggest that infection of the thoracic cord is more frequently seen, and that initial HSV-1 PCR may be negative. 25,27 Cerebrospinal fluid (CSF) examination typically demonstrates a lymphocytic pleocytosis, with a slightly raised protein and normal glucose. CSF testing for HSV-1 DNA by PCR is the mainstay of diagnosis of HSV-1, and is highly sensitive and specific.…”

Section: Key Messagesmentioning

confidence: 99%

Herpesvirus Infections of the Central Nervous System

2019

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There are over 200 herpesvirus species, of which 10 affect humans. Each of these 10 herpesviruses has a unique clinical syndrome, but common to all is their ability to cause infection and pathology in the central nervous system. In this article, we discuss the epidemiology, clinical presentation, diagnostic modalities, treatment, sequelae, and availability of vaccination of each of the following herpesviruses: herpes simplex virus 1 and 2, varicella zoster virus, human cytomegalovirus, human herpesvirus 6A, 6B, and 7, Epstein–Barr virus, human herpesvirus 8, and simian herpesvirus B.

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An unusual case of acute transverse myelitis caused by HSV-1 infection

Cited by 11 publications

References 4 publications

An improved animal model for herpesvirus encephalitis in humans

An improved animal model for herpesvirus encephalitis in humans

Acute urinary retention and progressive paraplegia with genital infection: A case report of transverse myelitis

Herpesvirus Infections of the Central Nervous System

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