Viral Infections of the Central Nervous System in Children: A Systematic Review

Abdullahi, Abba Musa; Sarmast, Shah T; Jahan, Nusrat

doi:10.7759/cureus.11174

Cited by 10 publications

(13 citation statements)

References 55 publications

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“…Neurological involvement in severe malaria is revealed by convulsions and/or coma [ 1 ]. These clinical features do not help with distinguishing cerebral malaria (CM) from other severe brain injuries, such as viral and bacterial central nervous system (CNS) infections [ 2 , 3 ], or other encephalopathies [ 4 ]. Mixed infections also occur and autopsy studies [ 5 ] have revealed cases of lethal meningitis in children with Plasmodium falciparum parasitemia.…”

Section: Introductionmentioning

confidence: 99%

“…Mixed infections also occur and autopsy studies [ 5 ] have revealed cases of lethal meningitis in children with Plasmodium falciparum parasitemia. Both CM and CNS infections are life-threatening conditions that require the administration of adequate medications [ 1 , 2 , 6 ]. In resource-limited countries, however, investigating the etiologies of non-traumatic coma is challenging.…”

Section: Introductionmentioning

confidence: 99%

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Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?

et al. 2022

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Background While malaria morbidity and mortality have declined since 2000, viral central nervous system infections appear to be an important, underestimated cause of coma in malaria-endemic Eastern Africa. We aimed to describe the etiology of non-traumatic comas in young children in Benin, as well as their management and early outcomes, and to identify factors associated with death. Methods From March to November 2018, we enrolled all HIV-negative children aged between 2 and 6 years, with a Blantyre Coma Score ≤ 2, in this prospective observational study. Children were screened for malaria severity signs and assessed using a systematic diagnostic protocol, including blood cultures, malaria diagnostics, and cerebrospinal fluid analysis using multiplex PCR. To determine factors associated with death, univariate and multivariate analyses were performed. Results From 3244 admissions, 84 children were included: malaria was diagnosed in 78, eight of whom had a viral or bacterial co-infection. Six children had a non-malarial infection or no identified cause. The mortality rate was 29.8% (25/84), with 20 children dying in the first 24 h. Co-infected children appeared to have a poorer prognosis. Of the 76 children who consulted a healthcare professional before admission, only 5 were prescribed adequate antimalarial oral therapy. Predictors of early death were jaundice or increased bilirubin [odd ratio (OR)= 8.6; 95% confidential interval (CI): 2.03–36.1] and lactate > 5 mmol/L (OR = 5.1; 95% CI: 1.49–17.30). Antibiotic use before admission (OR = 0.1; 95% CI: 0.02–0.85) and vaccination against yellow fever (OR = 0.2, 95% CI: 0.05–0.79) protected against mortality. Conclusions Infections were found in all children who died, and cerebral malaria was by far the most common cause of non-traumatic coma. Missed opportunities to receive early effective antimalarial treatment were common. Other central nervous system infections must be considered in their management. Some factors that proved to be protective against early death were unexpected.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?

et al. 2022

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“…It is considered the leading cause of sensorineural hearing loss (SNHL) in children and an important cause of neurodevelopmental delay. [ 12 ] The largest burden of tuberculosis (TB), and childhood tuberculous meningitis (TBM), is borne by low- and middle-income countries. [ 13 ]…”

Section: R Esultsmentioning

confidence: 99%

Psychosocial factors in brain infections research in the last decade: A scoping review

Nair

Thomas

Netravathi

2022

Indian J Community Med

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“…In herpes zoster cases, complications include vasculitis, zoster sine herpete, and post-herpetic neuralgia. A lack of early diagnosis results in treatment delays, which usually leads to fatalities, especially in newborns, elders, organ transplant recipients, and immunocompromised people experiencing disseminated herpes zoster [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Detection of Circulating VZV-Glycoprotein E-Specific Antibodies by Chemiluminescent Immunoassay (CLIA) for Varicella–Zoster Diagnosis

et al. 2022

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Varicella and herpes zoster are mild symptoms-associated diseases caused by varicella–zoster virus (VZV). They often cause severe complications (disseminated zoster), leading to death when diagnoses and treatment are delayed. However, most commercial VZV diagnostic tests have low sensitivity, and the most sensitive tests are unevenly available worldwide. Here, we developed and validated a highly sensitive VZV diagnostic kit based on the chemiluminescent immunoassay (CLIA) approach. VZV-glycoprotein E (gE) was used to develop a CLIA diagnostic approach for detecting VZV-specific IgA, IgG, and IgM. The kit was tested with 62 blood samples from 29 VZV-patients classified by standard ELISA into true-positive and equivocal groups and 453 blood samples from VZV-negative individuals. The diagnostic accuracy of the CLIA kit was evaluated by receiver-operating characteristic (ROC) analysis. The relationships of immunoglobulin-isotype levels between the two groups and with patient age ranges were analyzed. Overall, the developed CLIA-based diagnostic kit demonstrated the detection of VZV-specific immunoglobulin titers depending on sample dilution. From the ELISA-based true-positive patient samples, the diagnostic approach showed sensitivities of 95.2%, 95.2%, and 97.6% and specificities of 98.0%, 100%, and 98.9% for the detection of VZV-gE-specific IgA, IgG, and IgM, respectively. Combining IgM to IgG and IgA detection improved diagnostic accuracy. Comparative analyses on diagnosing patients with equivocal results displaying very low immunoglobulin titers revealed that the CLIA-based diagnostic approach is overall more sensitive than ELISA. In the presence of typical VZV symptoms, CLIA-based detection of high titer of IgM and low titer of IgA/IgG suggested the equivocal patients experienced primary VZV infection. Furthermore, while no difference in IgA/IgG level was found regarding patient age, IgM level was significantly higher in young adults. The CLIA approach-based detection kit for diagnosing VZV-gE-specific IgA, IgG, and IgM is simple, suitable for high-throughput routine analysis situations, and provides enhanced specificity compared to ELISA.

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Viral Infections of the Central Nervous System in Children: A Systematic Review

Cited by 10 publications

References 55 publications

Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?

Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?

Psychosocial factors in brain infections research in the last decade: A scoping review

Detection of Circulating VZV-Glycoprotein E-Specific Antibodies by Chemiluminescent Immunoassay (CLIA) for Varicella–Zoster Diagnosis

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