Herpes reactivation in patients with bacterial meningitis

Weerkamp, Nico J.; Beek, Diederik van de; Gans, Jan de; Koehler, Peter J.

doi:10.1016/j.jinf.2008.10.001

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…Not only HHV-6 but also CMV detections must be cautiously interpreted as both viruses are highly prevalent in the population and their amplification might correspond to primary infection, secondary reactivation or to a latent virus [23,33,34], as indicated in one of the system’s warning messages. Despite not having been observed in our study, reactivation of herpes viruses has also been described during bacterial meningitis [35,36]. The importance of correlating FA-M/E results with clinical and other biological data is confirmed in our study.…”

Section: Discussionsupporting

confidence: 81%

A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital

et al. 2019

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Early diagnosis and treatment of meningitis and encephalitis is essential for reducing both their morbidity and mortality. The FilmArray® Meningitis/Encephalitis (FA-M/E) panel is a recently available molecular tool allowing the simultaneous detection of 14 pathogens in about one hour. We evaluated its routine use over a 13-month period at Nîmes University Hospital, France. Cerebrospinal fluid (CSF) specimens were prospectively analyzed, independently of cell count; results were retrospectively analyzed and positive results compared to clinical and microbiological data. Among the 708 patients included (734 CSF samples), 89 (12.6%) had a positive FA-M/E panel, 71 (80%) for a viral pathogen and 18 (20%) for a bacterial pathogen. Enterovirus and HHV-6 were the main detected pathogens. Mean time-to-results was 1h46mn. Four non-clinically relevant results were detected (3 HHV-6 and 1 Haemophilus influenzae) on the basis of inconsistent clinical and/or biological data, and/or after visualization of melting curves. No CSF pleocytosis was observed in 11% of the patients with a positive FA-M/E panel. For the 18 patients with a positive FA-M/E panel for a bacterial pathogen, five (28%) had CSF samples showing a positive Gram stain allowing an early diagnosis of bacterial infection and 67% had CSF displaying a positive culture. Altogether the panel detected 5 cases of bacterial M/E (29%) not diagnosed by culture. Despite undeniable advantages, mainly ease of use, quick result availability, and an extremely low rate of invalid results, measures should be implemented to limit false-positive results due to contamination and a careful interpretation based on the overall data for each patient is required.

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Section: Discussionsupporting

confidence: 81%

A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital

et al. 2019

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“…This may simply be due to differing methodology, including the use of categorized data in the EMS nomogram, and the selection of categorical cutoffs may have been less appropriate for these younger African patients [18]. However, we believe that the poorer performance of the EMS in those settings highlights critical differences between developed and developing country ABM populations, including longer time to presentation, a higher prevalence of HIV and anemia, greater frequency of complications, and fewer resources available for clinical management [35, 36]. …”

Section: Discussionmentioning

confidence: 99%

Prediction of Outcome From Adult Bacterial Meningitis in a High-HIV-Seroprevalence, Resource-Poor Setting Using the Malawi Adult Meningitis Score (MAMS)

Wall

Mukaka

Scarborough³

et al. 2016

CLINID

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“…In patients affected by bacterial meningitis, herpes reactivation can occur as well. In a study of 301 patients with bacterial meningitis, 40 (13.3%) patients developed herpes reactivation, 10 (3.3%) of whom had clinical manifestations of VZV infections, while the rest (10%) had manifestations of HSV infections [ 18 ]. However, herpes reactivation in patients with bacterial meningitis due to Streptococcus agalactiae is an area less studied.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Group B Streptococcal Meningitis with Concomitant Varicella-Zoster Virus Infection in a Previously Healthy Male

Shahkarami¹,

Tafti²,

Alizadeh³

et al. 2022

Cureus

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Group B Streptococcus (GBS) is a well-known organism that can be part of the normal gastrointestinal and genital tract flora. However, it can cause various infections, mostly in neonates, pregnant women, and patients with predisposing factors. Meningitis caused by GBS, though common in neonates, is uncommon in adults, especially those with no previous health issues. Here, we present an unusual case of GBS meningitis in a 22-year-old previously healthy man. He came to the emergency room with complaints of acute headache and an altered level of consciousness, and his cerebrospinal fluid analysis was consistent with bacterial meningitis due to Streptococcus agalactiae. Later, vesicular lesions on his face caused by varicellazoster virus (VZV) infection complicated his situation. He received intravenous ceftriaxone and dexamethasone and oral acyclovir. He had a complete recovery and was discharged without any sequelae. Though uncommon, this serious condition needs prompt diagnosis and treatment due to its high mortality rate. To our knowledge, this is one of the few known cases of GBS meningitis in a previously healthy adult and the only one to report VZV infection as a possible complication.

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Herpes reactivation in patients with bacterial meningitis

Cited by 7 publications

References 7 publications

A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital

A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital

Prediction of Outcome From Adult Bacterial Meningitis in a High-HIV-Seroprevalence, Resource-Poor Setting Using the Malawi Adult Meningitis Score (MAMS)

An Unusual Case of Group B Streptococcal Meningitis with Concomitant Varicella-Zoster Virus Infection in a Previously Healthy Male

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