CLINICAL AND SUB-CLINICAL CHARACTERISTICS OF MENINGITIS CAUSED BY VARICELLA ZOSTER VIRUS

Nguyen Dinh Dung1,, Vu Minh Dien2, Bui Vu Huy1
1 Hanoi Medical University
2 National Hospital for Tropical Diseases

Nội dung chính của bài viết

Tóm tắt

Encephalitis - meningitis today is still a serious public health problem with a high mortality rate.
Objectives: To describe the clinical and subclinical characteristics of encephalitis-meningitis caused by Varicella zoster virus (VZV) in people from 15 years old.
Material and methods: A retrospective descriptive research on 40 patients with encephalitis-meningitis diagnosed based on positive VZV PCR results in cerebrospinal fluid treated at the National Hospital of Tropical Diseases and Bach Mai Hospital from January 2020 to June 2023.
Results: Common clinical manifestations of VZV meningitis are headache (90.6%), fever (59.4%), and nausea (43.8%). Common manifestations of encephalitis are behavioral and language disorders (75%), and fever (50%). In the cerebrospinal fluid, the median number of white blood cells in the two meningitis and encephalitis groups were 235.5 (100 - 440) cells/mL and 157 (46 - 497) cells/mL, respectively, of which white blood cells were lymphocytes predominate, protein of the two meningitis and encephalitis groups are 1.0 (0.5 - 1.6) G/L and 2.1 (0.9 - 5.7) G/L, respectively. We can find out brain damage on CT or MRI in the temporal lobe, frontal lobe, and insula lobe. In addition, demyelinating lesions occur in 25%.

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Tài liệu tham khảo

1. J. David Beckham và Kenneth L. Tyler (2020). Encephalitis, chapter 89, Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, Editor John E. bennett, 9 edition, Publishing house Elsevier, Philadelphia: 1226- 1247.
2. Rodrigo Hasbun, Diederik van de Beek, Matthijs C. Brouwer, Allan R. Tunkel (2020). Acute Meningitis, chapter 87, Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, Editor John E. bennett, 9 edition, Elsevier Philadelphia: 1183-1219.
3. Gaudin M, Theïs C, Mrozek N, et al. Varicella zoster virus and meningitis in immunocompetent patients: Specificity and questions. Clinical Infection in Practice. 2022;13:100125. doi:10.1016/j.clinpr.2021.100125.
4. Koskiniemi M, Rantalaiho T, Piiparinen H, et al. Infections of the central nervous system of suspected viral origin: a collaborative study from Finland. J Neurovirol. 2001;7(5):400-408. doi:10.1080/135502801753170255.
5. Becerra JCL, Sieber R, Martinetti G, Costa ST, Meylan P, Bernasconi E. Infection of the central nervous system caused by varicella zoster virus reactivation: a retrospective case
series study. International Journal of Infectious Diseases. 2013;17(7):e529-e534. doi:10.1016/j.ijid.2013.01.031.
6. Alvarez JC, Alvarez J, Tinoco J, et al. Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections. Cureus. 2020;12(11):e11583. doi:10.7759/cureus.11583.
7. Venkatesan A, Tunkel AR, Bloch KC, et al. Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis: Consensus Statement of the International Encephalitis Consortium. Clinical Infectious Diseases. 2013;57(8):1114-1128. doi:10.1093/cid/cit458.
8. Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective.
BMJ Open. 2014;4(6):e004833. doi:10.1136/ bmjopen-2014-004833.
9. Broucker TD, Mailles A, Chabrier S, Morand P, Stahl JP, Group OB of the SC and I. Acute varicella zoster encephalitis without evidence of primaryvasculopathy in a case-series of 20 patients. Clinical Microbiology and Infection. 2012;18(8):808-819.doi:10.1111/j.1469-0691.2011.03705.x
10. Tabaja H, Sharara SL, Abi Aad Y, et al. Varicella zoster virus infection of the central nervous system in a tertiary care center in Lebanon. Médecine et Maladies Infectieuses. 2020;50(3):280-287.doi:10.1016/j.medmal.2019.08.005.
11. Herlin LK, Hansen KS, Bodilsen J, et al. Varicella Zoster Virus Encephalitis in Denmark From 2015 to 2019—A Nationwide Prospective Cohort Study. Clinical Infectious Diseases. 2021;72(7):1192-1199. doi:10.1093/cid/ciaa185.
12. Bui Vu Huy, Vu Minh Dien. Research on clinical characteristics and prognostic factors of Herpes simplex encephalitis. Journal of Medical Research. 2011;74(3):147-155.
13. Mirouse A, Sonneville R, Razazi K, et al. Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study. Ann Intensive Care. 2022; 12:32. doi:10.1186/s13613-022-01002-y.