Viral etiologies in adult patients with encephalitis in Poland: A prospective single center study

Abstract

Encephalitis is a severe neurological syndrome associated with high morbidity and mortality as well as long-term neurological sequelae. Despite being an important public health problem, very few extensive population-based studies were conducted so far in the world and none in Central Europe. Altogether 114 consecutive patients meeting the initial criteria for encephalitis were enrolled at the Warsaw Hospital for Infectious Diseases between June 2012 and July 2015. Eighteen patients were secondarily excluded from the analysis due to incomplete data or noinfectious cause. Potential pathogen sequences were searched for by molecular methods in the cerebrospinal fluid (CSF) and specific antibodies were detected in CSF and sera. An infectious agent was identified in 41 patients (42.7%). The most frequently diagnosed infections were Human herpesvirus 1 (HHV-1) (22 cases, 24%) followed by Enterovirus (6 cases, 6.3%), Varicella zoster virus (VZV) (5 cases, 5.2%), Tick-borne encephalitis virus (TBEV) (6 cases, 6.3%) and Cytomegalovirus (CMV) (2 cases, 2.1%). There were no cases of human adenovirus, Human herpesvirus 6 (HHV-6) or West Nile virus (WNV) infection identified. In 55 cases (57.3%) the cause of encephalitis remained unknown. Compared to patients in whom the diagnosis was determined the latter group contained more women, was less likely to manifest fever and had lower CSF pleocytosis (p < 0.05) In summary, we identified HHV-1 followed by Enterovirus, VZV and TBEV as the most common causes of encephalitis among adult patients in Poland. In a large proportion of patients the cause of encephalitis remained unknown.

Detection of central nervous system viral infections in adults in Manado, North Sulawesi, Indonesia

“…In spite of the small sample size, the finding of HSV-1 as the predominantly identified virus in this study was consistent with others from Vietnam [22], India [23], Norway [24], and Poland [25], while other studies in Vietnam [26] and Thailand [27] reported JEV as the most common identified viral cause of CNS infection. Furthermore, recent studies in China [28] and Italy [29] found EV as the primary identified viral pathogen causing CNS diseases.…”

“…Fifth, MRI which is more sensitive than CT, was not performed under resource-limited healthcare settings. Sixth, the prevalence of etiological agents detected in this study might be low compared with other studies [25,26,28,29,47], possibly due to the different molecular tools used (pan-family vs virus-specific PCR/RT-PCR) and case selection methods (suspected CNS infection vs encephalitis/meningoencephalitis only). Seventh, with a small sample size, our conclusions on viral etiology might not be statistically significant.…”

Meningitis and encephalitis in Poland in 2016

“…Przyczyną zapalenia opon mózgowo-rdzeniowych i/lub mózgu mogą być różnorodne czynniki zakaźne, głównie bakteryjne i wirusowe, ale także grzyby i pierwotniaki. Klinicznie mogą również wynikać z czynników autoimmunologicznych i warunków paraneoplastycznych (1). Wśród zachorowań na zapalenie opon mózgowo-rdzeniowych i/lub mózgu, potwierdzonych badaniem laboratoryjnym najczęściej występują zachorowania wywołane przez Neisseria meningitidis i Streptococcus pneumoniae.…”

“…Clinically, they may also result from autoimmune factors and paraneoplastic conditions. (1) The incidence of meningitis and / or encephalomyelitis, confirmed by laboratory tests, is most often caused by Neisseria meningitidis and Streptococcus pneumoniae. Among viral neuroinfections, tick-borne encephalitis predominates.…”

Human Pegivirus in Patients with Encephalitis of Unclear Etiology, Poland

“…Of these 3 studies, none included comparison of serum- and CNS-derived virus. We conducted a study of 96 consecutive patients with diagnosis of encephalitis ( 18 ) in Poland during 2012–2015 to determine whether HPgV could be found in the CNS.…”