Co-infection with Mycoplasma pneumoniae and Human Herpesvirus 6 (HHV-6) in an Immunocompetent Child with Meningoencephalitis: a Random Association?

Vianello, Fabrizio; Barbaro, Francesco; Cogo, Paola; Furlan, Antonio; Trevenzoli, Marco; Sgarabotto, Dino

doi:10.1007/s15010-007-6249-y

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…The high frequency of HHV-6 DNA detection in the CSF of encephalitis patients is consistent with a number of recent studies14, 17–20, 31 that suggest a possible role of HHV-6 in neurological complications. To extend the significance of this observation, we asked whether host immune response against HHV-6 could also be detected in the CSF of encephalitis patients with unknown etiology.…”

Section: Resultssupporting

confidence: 90%

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Yao

Honarmand²,

Espinosa³

et al. 2009

Annals of Neurology

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Objective Virus infections are the most common causes of encephalitis, a syndrome characterized by acute inflammation of the brain. Over 150 different viruses have been implicated in the pathogenesis of encephalitis, however due to limitations with diagnostic testing, etiologies of over half of the cases remain unknown. Methods To investigate whether HHV-6 is an etiological agent of encephalitis, we examined for evidence of virus infection by determining the presence of viral sequence using PCR and assessed HHV-6 antibody reactivity in the cerebrospinal fluids (CSF) of encephalitis patients with unknown etiology. In a cohort study, we compared virus specific antibody levels in CSF samples of patients with encephalitis, relapsing-remitting MS and other neurologic diseases (OND). Results Our results demonstrated elevated levels of HHV-6 IgG as well as IgM levels in a subset of encephalitis patients compared with OND. Moreover, cell-free viral DNA that is indicative of active infection was detected in 40% (14/35) of encephalitis patients, while no amplifiable viral sequence was found in either relapsing-remitting MS or OND patients. Additionally, a significant correlation between PCR detection and anti-HHV-6 antibody response was also demonstrated. Interpretation Collectively, these results suggested HHV-6 as a possible pathogen in a subset of encephalitis cases.

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Section: Resultssupporting

confidence: 90%

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Yao

Honarmand²,

Espinosa³

et al. 2009

Annals of Neurology

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show abstract

“…The high frequency of HHV‐6 DNA detection in the CSF of encephalitis patients is consistent with a number of recent studies14, 17–20, 31 that suggest a possible role of HHV‐6 in neurological complications. To extend the significance of this observation, we asked whether host immune response against HHV‐6 could also be detected in the CSF of patients with encephalitis of unknown cause.…”

Section: Resultssupporting

confidence: 90%

“…Similarly, we were able to show that RRMS patients and post‐BMT recipients with neurological complications also had increased IgG reactivity against HHV‐6 in their CSF. This finding is consistent with previous observations that suggested an association of HHV‐6 with neurological disorders 8, 9, 13, 17–22. To better evaluate the percentage of patients with increased CSF HHV‐6 IgG reactivity, we empirically defined the background HHV‐6 IgG level in the CSF as three standard deviations greater than the mean HHV‐6 IgG value of OND patients.…”

Section: Resultssupporting

confidence: 86%

“…Given the associations of HHV‐6 with neurological disorders, it was of interest to examine whether there was a relation with HHV‐6 infection or reactivation in patients with unknown origin of encephalitis. HHV‐6 has been associated with a wide spectrum of neurological disorders including febrile seizure, epilepsy, multiple sclerosis, and encephalitis 8, 9, 13, 17–22. A member of the β‐herpesvirus family, HHV‐6 is most closely related to the human cytomegalovirus based on sequence homology and also possesses the characteristic property of becoming latent in the host after primary infection and reactivating later in life.…”

mentioning

confidence: 99%

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Combination of paclitaxel and carboplatin as second‐line therapy for patients with metastatic melanoma

Rao

Holtan

Ingle

et al. 2005

Cancer

107

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Objective Virus infections are the most common causes of encephalitis, a syndrome characterized by acute inflammation of the brain. More than 150 different viruses have been implicated in the pathogenesis of encephalitis; however, because of limitations with diagnostic testing, causative factors of more than half of the cases remain unknown. Methods To investigate whether human herpesvirus‐6 (HHV‐6) is a causative agent of encephalitis, we examined for evidence of virus infection by determining the presence of viral sequence using polymerase chain reaction and assessed HHV‐6 antibody reactivity in the cerebrospinal fluid of encephalitis patients with unknown cause. In a cohort study, we compared virus‐specific antibody levels in cerebrospinal fluid samples of patients with encephalitis, relapsing‐remitting multiple sclerosis, and other neurological diseases. Results Our results demonstrated increased levels of HHV‐6 IgG, as well as IgM levels, in a subset of encephalitis patients compared with other neurological diseases. Moreover, cell‐free viral DNA that is indicative of active infection was detected in 40% (14/35) of encephalitis patients, whereas no amplifiable viral sequence was found in either relapsing‐remitting MS or other neurological diseases patients. In addition, a significant correlation between polymerase chain reaction detection and anti‐HHV‐6 antibody response was also demonstrated. Interpretation Collectively, these results suggested HHV‐6 as a possible pathogen in a subset of encephalitis cases. Ann Neurol 2009;65:257–267

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“…Dual infections in CNS infection, such as among members of herpesviruses or between a member of this group and a bacterium, have previously been reported in both immunocompetent and immunocompromised patients diagnosed using PCR methods and/or intrathecal antibody determinations [51]–[56]. In this study, we found 20 dual infection cases in 1241 suspected CNS infection patients.…”

Section: Discussionmentioning

confidence: 57%

Aetiologies of Central Nervous System Infection in Viet Nam: A Prospective Provincial Hospital-Based Descriptive Surveillance Study

et al. 2012

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BackgroundInfectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.MethodsWe conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007– April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.ResultsWe recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.ConclusionsZoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

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Co-infection with Mycoplasma pneumoniae and Human Herpesvirus 6 (HHV-6) in an Immunocompetent Child with Meningoencephalitis: a Random Association?

Cited by 4 publications

References 13 publications

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Detection of human herpesvirus‐6 in cerebrospinal fluid of patients with encephalitis

Combination of paclitaxel and carboplatin as second‐line therapy for patients with metastatic melanoma

Aetiologies of Central Nervous System Infection in Viet Nam: A Prospective Provincial Hospital-Based Descriptive Surveillance Study

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