Managing atypical and typical herpetic central nervous system
infections: results of a multinational study

J 2016

Managing atypical and typical herpetic central nervous system infections: results of a multinational study

CAG, Y., H. ERDEM, S. LEIB, S. DEFRES, S. KAYA et. al.

Basic information

Original name

Managing atypical and typical herpetic central nervous system infections: results of a multinational study

Name in Czech

Diagnostika a léčba atypické a typické herpetické infekce centrálního nervového systému: výsledky mezinárodní studie

Authors

CAG, Y. (792 Turkey), H. ERDEM (792 Turkey), S. LEIB (756 Switzerland), S. DEFRES (826 United Kingdom of Great Britain and Northern Ireland), S. KAYA (792 Turkey), L. LARSEN (208 Denmark), M. POLJAK (705 Slovenia), D. OZTURK-ENGIN (792 Turkey), B. BARSIC (191 Croatia), X. ARGEMI (250 France), S.M. SORENSEN (208 Denmark), A.L. BOHR (208 Denmark), P. TATTEVIN (250 France), J.D. GUNST (208 Denmark), Lenka BAŠTÁKOVÁ (703 Slovakia, guarantor, belonging to the institution), M. JEREB (705 Slovenia), I.S. JOHANSEN (208 Denmark), O. KARABAY (792 Turkey), A.U. PEKOK (792 Turkey), O.R. SIPAHI (792 Turkey), M. CHEHRI (208 Denmark), G. BERAUD (250 France), G. SHEHATA (818 Egypt), R. FONTANA (380 Italy), M. MARESCA (380 Italy), H. KARSEN (792 Turkey), G. SENGOZ (792 Turkey), M. SUNBUL (792 Turkey), G. YILMAZ (792 Turkey), H. YILMAZ (792 Turkey), A. SHARIF-YAKAN (422 Lebanon), S. KANJ (422 Lebanon), E. PARLAK (792 Turkey), F. PEHLIVANOGLU (792 Turkey), F. KORKMAZ (792 Turkey), S. KOMUR (792 Turkey), S. KOSE (792 Turkey), M. ULUG (792 Turkey), S. BOLUKCU (792 Turkey), S.A. COSKUNER (792 Turkey), J.P. STAHL (250 France), N. INCE (792 Turkey), Y. AKKOYUNLU (792 Turkey), G. HALAC (792 Turkey), E. SAHIN-HORASAN (792 Turkey), H. TIRELI (792 Turkey), G. KILICOGLU (792 Turkey), A. AL-MAHDAWI (368 Iraq), S.A. NEMLI (792 Turkey), A. INAN (792 Turkey), S. SENBAYRAK (792 Turkey), H. VAHABOGLU (792 Turkey) and N. ELALDI (792 Turkey)

Edition

Clinical Microbiology and Infection, NJ USA, WILEY-BLACKWELL, 2016, 1198-743X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

10600 1.6 Biological sciences

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 5.292

RIV identification code

RIV/00216224:14110/16:00090667

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.cmi.2016.03.027

UT WoS

000379252100027

Keywords (in Czech)

atypická prezentace; encefalitida; herpes simplex virus; diagnostika; meningitida

Keywords in English

Atypical presentation; encephalitis; herpes simplex virus; managing; meningitis

Abstract

ORIG CZ

V originále

There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection.

In Czech

Do dnešní doby bylo provedeno množství studií zabývajících se diagnostikou a léčbou herpetické meningoencefalitidy, avšak většina z nich se týkala virologicky nepotvrzených případů či zahrnovala malé množství pacientů. S cílem navrhnout diagnostickou a léčebnou strategii pro pacienty s herpetickou meningoencefalitidou byla provedena retrospektivní mezinárodní studie. Do souboru bylo zahrnutých celkem 501 dospělých pacientů z 35 center v 10 zemích, z toho 496 pacientů bylo vhodných k další analýze. PCR vyšetření mozkomíšního moku prokázalo DNA viru herpes simplex (HSV) typ l u 351 pacientů (70,8 %), HSV typ 2 u 83 pacientů (16,7 %) a nedefinovatelnou HSV DNA u 62 pacientů (12,5 %). U 379 pacientů (76,4 %) byl přítomen alespoň l příznak charakteristický pro encefalitidu a tito pacienti byly zařazeni do skupiny s encefalitidou. Zbývajících 117 pacientů (23,6 %) nemělo žádný z těchto příznaků a bylo zařazeno do skupiny bez encefalitidy. Ve skupině pacientů s klinickým nálezem encefalitidy byly abnormality indikující encefalitidu detekovány vyšetřením magnetickou rezonancí (MŘI) u 83,9 % pacientů a elektroencefalograficky (EEG) u 91,0 % pacientů. Ve skupině bez encefalitidy byly MŘI a EEG nálezy pozitivní v 33,3 % a 61,9 % pacientů. Současné použití MŘI a EEG popsalo encefalitidu u 96,3% pacientů s příznaky encefalitidy a u 87,5% bez klinického korelátu encefalitidy. Vzhledem k povaze herpetické meningoencefalitidy, HSV PCR mozkomíšního moku, EEG a MŘI vyšetření by měly být provedeny u všech pacientů s infekcí centrálního nervového systému.

Citovat

CAG, Y., H. ERDEM, S. LEIB, S. DEFRES, S. KAYA, L. LARSEN, M. POLJAK, D. OZTURK-ENGIN, B. BARSIC, X. ARGEMI, S.M. SORENSEN, A.L. BOHR, P. TATTEVIN, J.D. GUNST, Lenka BAŠTÁKOVÁ, M. JEREB, I.S. JOHANSEN, O. KARABAY, A.U. PEKOK, O.R. SIPAHI, M. CHEHRI, G. BERAUD, G. SHEHATA, R. FONTANA, M. MARESCA, H. KARSEN, G. SENGOZ, M. SUNBUL, G. YILMAZ, H. YILMAZ, A. SHARIF-YAKAN, S. KANJ, E. PARLAK, F. PEHLIVANOGLU, F. KORKMAZ, S. KOMUR, S. KOSE, M. ULUG, S. BOLUKCU, S.A. COSKUNER, J.P. STAHL, N. INCE, Y. AKKOYUNLU, G. HALAC, E. SAHIN-HORASAN, H. TIRELI, G. KILICOGLU, A. AL-MAHDAWI, S.A. NEMLI, A. INAN, S. SENBAYRAK, H. VAHABOGLU and N. ELALDI. Managing atypical and typical herpetic central nervous system infections: results of a multinational study. Clinical Microbiology and Infection. NJ USA: WILEY-BLACKWELL, 2016, vol. 22, No 6, p. "nestránkováno", 9 pp. ISSN 1198-743X. Available from: https://dx.doi.org/10.1016/j.cmi.2016.03.027.

@article{1352752,
   author = {Cag, Y. and Erdem, H. and Leib, S. and Defres, S. and Kaya, S. and Larsen, L. and Poljak, M. and OzturkandEngin, D. and Barsic, B. and Argemi, X. and Sorensen, S.M. and Bohr, A.L. and Tattevin, P. and Gunst, J.D. and Baštáková, Lenka and Jereb, M. and Johansen, I.S. and Karabay, O. and Pekok, A.U. and Sipahi, O.R. and Chehri, M. and Beraud, G. and Shehata, G. and Fontana, R. and Maresca, M. and Karsen, H. and Sengoz, G. and Sunbul, M. and Yilmaz, G. and Yilmaz, H. and SharifandYakan, A. and Kanj, S. and Parlak, E. and Pehlivanoglu, F. and Korkmaz, F. and Komur, S. and Kose, S. and Ulug, M. and Bolukcu, S. and Coskuner, S.A. and Stahl, J.P. and Ince, N. and Akkoyunlu, Y. and Halac, G. and SahinandHorasan, E. and Tireli, H. and Kilicoglu, G. and AlandMahdawi, A. and Nemli, S.A. and Inan, A. and Senbayrak, S. and Vahaboglu, H. and Elaldi, N.},
   article_location = {NJ USA},
   article_number = {6},
   doi = {http://dx.doi.org/10.1016/j.cmi.2016.03.027},
   keywords = {Atypical presentation; encephalitis; herpes simplex virus; managing; meningitis},
   language = {eng},
   issn = {1198-743X},
   journal = {Clinical Microbiology and Infection},
   title = {Managing atypical and typical herpetic central nervous system infections: results of a multinational study},
   volume = {22},
   year = {2016}
}

TY  - JOUR
ID  - 1352752
AU  - Cag, Y. - Erdem, H. - Leib, S. - Defres, S. - Kaya, S. - Larsen, L. - Poljak, M. - Ozturk-Engin, D. - Barsic, B. - Argemi, X. - Sorensen, S.M. - Bohr, A.L. - Tattevin, P. - Gunst, J.D. - Baštáková, Lenka - Jereb, M. - Johansen, I.S. - Karabay, O. - Pekok, A.U. - Sipahi, O.R. - Chehri, M. - Beraud, G. - Shehata, G. - Fontana, R. - Maresca, M. - Karsen, H. - Sengoz, G. - Sunbul, M. - Yilmaz, G. - Yilmaz, H. - Sharif-Yakan, A. - Kanj, S. - Parlak, E. - Pehlivanoglu, F. - Korkmaz, F. - Komur, S. - Kose, S. - Ulug, M. - Bolukcu, S. - Coskuner, S.A. - Stahl, J.P. - Ince, N. - Akkoyunlu, Y. - Halac, G. - Sahin-Horasan, E. - Tireli, H. - Kilicoglu, G. - Al-Mahdawi, A. - Nemli, S.A. - Inan, A. - Senbayrak, S. - Vahaboglu, H. - Elaldi, N.
PY  - 2016
TI  - Managing atypical and typical herpetic central nervous system infections: results of a multinational study
JF  - Clinical Microbiology and Infection
VL  - 22
IS  - 6
SP  - "nestránkováno"
EP  - "nestránkováno"
PB  - WILEY-BLACKWELL
SN  - 1198743X
KW  - Atypical presentation
KW  - encephalitis
KW  - herpes simplex virus
KW  - managing
KW  - meningitis
N2  - There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection.
ER  -

CAG, Y., H. ERDEM, S. LEIB, S. DEFRES, S. KAYA, L. LARSEN, M. POLJAK, D. OZTURK-ENGIN, B. BARSIC, X. ARGEMI, S.M. SORENSEN, A.L. BOHR, P. TATTEVIN, J.D. GUNST, Lenka BAŠTÁKOVÁ, M. JEREB, I.S. JOHANSEN, O. KARABAY, A.U. PEKOK, O.R. SIPAHI, M. CHEHRI, G. BERAUD, G. SHEHATA, R. FONTANA, M. MARESCA, H. KARSEN, G. SENGOZ, M. SUNBUL, G. YILMAZ, H. YILMAZ, A. SHARIF-YAKAN, S. KANJ, E. PARLAK, F. PEHLIVANOGLU, F. KORKMAZ, S. KOMUR, S. KOSE, M. ULUG, S. BOLUKCU, S.A. COSKUNER, J.P. STAHL, N. INCE, Y. AKKOYUNLU, G. HALAC, E. SAHIN-HORASAN, H. TIRELI, G. KILICOGLU, A. AL-MAHDAWI, S.A. NEMLI, A. INAN, S. SENBAYRAK, H. VAHABOGLU and N. ELALDI. Managing atypical and typical herpetic central nervous system infections: results of a multinational study. \textit{Clinical Microbiology and Infection}. NJ USA: WILEY-BLACKWELL, 2016, vol.~22, No~6, p.~''nestránkováno'', 9 pp. ISSN~1198-743X. Available from: https://dx.doi.org/10.1016/j.cmi.2016.03.027.

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