Suspected Neuro-invasive Powassan Virus Infection in a Pediatric Patient

Koester, Trever M.; Timothy, Priyanka; Osborn, Rebecca; Frost, Holly M.

doi:10.3121/cmr.2020.1512

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Powassan virus (POWV) encephalitis was first reported in 1958, when the titer of POWV, a neuroinvasive arbovirus, was detected from the brain autopsy of a young boy who died in Powassan, Ontario [ 42 ]. It is a tickborne flavivirus-induced [ 43 , 44 ] disease that displays a wide spectrum of neuroinflammatory responses [ 45 ] in the brain and spinal cord including compromised blood–brain barrier integrity, enhanced infiltration of inflammatory T cells [ 46 , 47 ], severe microglial activation [ 47 ], and demyelination [ 48 ] of oligodendrocytes resulting neuronal toxicity. While it is not known if POWV can induce a similar acute immunosuppressive mechanism as seen in HHV6, a recent study [ 49 ] demonstrated that there is a robust proliferation of reactive Th1 cells in the spleens of the POWV-infected mice.…”

Section: Introductionmentioning

confidence: 99%

Potential molecular mechanisms of chronic fatigue in long haul COVID and other viral diseases

Gottschalk

Peterson²,

Armstrong³

et al. 2023

Infect Agents Cancer

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Historically, COVID-19 emerges as one of the most devastating diseases of humankind, which creates an unmanageable health crisis worldwide. Until now, this disease costs millions of lives and continues to paralyze human civilization's economy and social growth, leaving an enduring damage that will take an exceptionally long time to repair. While a majority of infected patients survive after mild to moderate reactions after two to six weeks, a growing population of patients suffers for months with severe and prolonged symptoms of fatigue, depression, and anxiety. These patients are no less than 10% of total COVID-19 infected individuals with distinctive chronic clinical symptomatology, collectively termed post-acute sequelae of COVID-19 (PASC) or more commonly long-haul COVID. Interestingly, Long-haul COVID and many debilitating viral diseases display a similar range of clinical symptoms of muscle fatigue, dizziness, depression, and chronic inflammation. In our current hypothesis-driven review article, we attempt to discuss the molecular mechanism of muscle fatigue in long-haul COVID, and other viral diseases as caused by HHV6, Powassan, Epstein–Barr virus (EBV), and HIV. We also discuss the pathological resemblance of virus-triggered muscle fatigue with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Graphical Abstract

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Section: Introductionmentioning

confidence: 99%

Potential molecular mechanisms of chronic fatigue in long haul COVID and other viral diseases

Gottschalk

Peterson²,

Armstrong³

et al. 2023

Infect Agents Cancer

View full text Add to dashboard Cite

show abstract

“…Few cases have been reported in the US (189 cases total 2012-2021, CDC ArboNET), with most symptomatic individuals presenting with fever, headache, and weakness ( 166 ). Among children, cases remain limited predominantly to case reports ( 167 ). No cases of Powassan virus infection among pediatric SOT recipients have been reported, though an adult renal transplant recipient developed acute Powassan virus meningoencephalitis with transmission through receipt of blood products ( 168 ).…”

Section: Causative Viral Pathogensmentioning

confidence: 99%

Viral meningoencephalitis in pediatric solid organ or hematopoietic cell transplant recipients: a diagnostic and therapeutic approach

Thomas,

Ouellette

2024

Front. Pediatr.

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Neurologic complications, both infectious and non-infectious, are frequent among hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients. Up to 46% of HCT and 50% of SOT recipients experience a neurological complication, including cerebrovascular accidents, drug toxicities, as well as infections. Defects in innate, adaptive, and humoral immune function among transplant recipients predispose to opportunistic infections, including central nervous system (CNS) disease. CNS infections remain uncommon overall amongst HCT and SOT recipients, compromising approximately 1% of total cases among adult patients. Given the relatively lower number of pediatric transplant recipients, the incidence of CNS disease amongst in this population remains unknown. Although infections comprise a small percentage of the neurological complications that occur post-transplant, the associated morbidity and mortality in an immunosuppressed state makes it imperative to promptly evaluate and aggressively treat a pediatric transplant patient with suspicion for viral meningoencephalitis. This manuscript guides the reader through a broad infectious and non-infectious diagnostic differential in a transplant recipient presenting with altered mentation and fever and thereafter, elaborates on diagnostics and management of viral meningoencephalitis. Hypothetical SOT and HCT patient cases have also been constructed to illustrate the diagnostic and management process in select viral etiologies. Given the unique risk for various opportunistic viral infections resulting in CNS disease among transplant recipients, the manuscript will provide a contemporary review of the epidemiology, risk factors, diagnosis, and management of viral meningoencephalitis in these patients

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A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus

Fareed,

Rohail,

Zameer

et al. 2024

Therapeutic Advances in Infection

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Powassan virus (POWV), a tick-borne flavivirus transmitted primarily by Ixodes ticks, poses a significant threat as it can lead to severe neuroinvasive illness. This review delves into the nuanced clinical presentation of Powassan infection, a challenge in diagnosis exacerbated by the absence of an available vaccine. Over the past decade, the prevalence of POWV has surged in North America, necessitating a thorough examination of its neurological manifestations alongside tick-borne encephalitis virus (TBEV). A comprehensive literature search conducted up to January 2024 revealed 135 cases of neurological symptoms associated with either Powassan or TBEV infection. Notably, severe occipital headache emerged as the most prevalent symptom (22.75%), followed by meningoencephalitis (10.34%), seizures (8.27%), and flaccid paresis (6.8%). Additional manifestations included poor balance, wide gait, dysarthria, facial nerve palsy, seizure, slurred speech, and absent deep tendon reflexes. Tragically, nine cases resulted in fatal outcomes attributed to POWV infection. This analysis highlights the intricate spectrum of neurological symptoms associated with Powassan infection and underscores the necessity for heightened awareness among medical practitioners, particularly in regions with a higher prevalence of the virus. The complexity of symptoms emphasizes the need for further research to unravel the factors contributing to this diversity. Additionally, exploring potential treatment avenues and vaccine development is crucial in addressing the rising threat posed by POWV, ultimately enhancing our ability to manage and prevent severe neurological outcomes.

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Suspected Neuro-invasive Powassan Virus Infection in a Pediatric Patient

Cited by 4 publications

References 6 publications

Potential molecular mechanisms of chronic fatigue in long haul COVID and other viral diseases

Potential molecular mechanisms of chronic fatigue in long haul COVID and other viral diseases

Viral meningoencephalitis in pediatric solid organ or hematopoietic cell transplant recipients: a diagnostic and therapeutic approach

A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus

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