VZV Virus Research Articles

EXPECT THE UNEXPECTED: A CASE OF VZV-INDUCED HYDRCEPALUS IN A PATIENT WITH RECURRENCE OF CLL

TYPE: Abstract TOPIC: Critical Care INTRODUCTION: Varicella-Zoster virus followed by herpes virus is the 2 most common viral causes of acute Encephalitis/Meningitis, especially in immunocompromised patients. Reactivation of VZV, after the primary chickenpox, generally presents as vesicular rash in one or more dermatomes, preceding or following the main manifestation. Neurological symptoms by VZV are well documented in the elderly, but it is rare to cause hydrocephalus. CASE PRESENTATION: A case of a 70-year-old male with a past medical history of Chronic Lymphocytic Leukemia about 23 years ago presented to the emergency department due to persistent nausea, vomiting, diarrhea, headache, and weakness for 5 days. After the first laboratory examination, a diagnosis of recurrence of CLL was made. He became increasingly lethargic and was started on Ceftriaxone, Azithromycin, and Acyclovir for suspicion of encephalitis. CSF PCR panel was positive for VZV and rhinovirus, negative for bands. He was intubated for airway protection. He underwent leukapheresis twice to reduce leukostasis. On Day 3 of the ICU stay, he remained obtunded, CT head revealed developing hydrocephalus, an external ventricular drain was placed. Repeat CSF revealed persistent positive VZV virus. Over the next few days, he remained comatose with no movements or improvement in neurological status and eventually passed away. DISCUSSION: Immunocompromised patients who have impaired T-cell mediated immunity are prone to viral encephalitis. This is the first reported case of VZV-induced hydrocephalus. CONCLUSIONS: It is important to raise awareness of the risk of VZV reactivation with severe neurological complications in patients with reactivation of malignancy. Acyclovir should be initiated early to prevent complications. DISCLOSURE: Nothing to declare. KEYWORD: VZV

Characterization of binding of Varicella zoster virus vaccine strains to preparations of mouse brain membrane receptors

Purpose: characterization of vFiraVax (the causative agent of chickenpox - VZV) and vZelVax (the causative agent of shingles - HZ) vaccine strains by their ability to bind to preparations of brain membrane receptors of SPF BALB/c mice.Materials and Methods. The study was performed on cold-adapted vFiraVax VZV and vZelVax HZ vaccine strains developed by the authors on the basis of the wild-type parental pFira VZV virus (chickenpox causative agent) and the latent parental lpZel HZ virus (shingles causative agent); vOka vaccine strains isolated from vaccines against VZV infection from two manufactures (United Kingdom and USA); the HEL-3 strain of diploid cells from human embryonic lung tissue, the MC 27 strain of diploid cells from human embryonic musculocutaneous tissue, primary and diploid cells from guinea pig fetal fibroblasts. The VZV infectivity was estimated by the limiting dilution method using MC 27 cell cultures or guinea pig fetal fibroblasts. The virus titer was measured by the hemadsorption test performed with suspensions of red blood cells from guinea pig or human type 0 positive blood. Negative staining and electron microscopy were used to study the virus preparation. The immunogenicity of vFiraVax VZV and vZelVax HZ virus strains was compared with the immunogenicity of vOka VZV virus strains from different manufacturers by using a cross-neutralization test with immune sera.Results. The Russian cold-adapted vFiraVax VZV and vZelVax HZ vaccine strains, the latent parental lpZel HZ virus and the vOka VZV vaccine strain (United Kingdom) did not bind to preparations of brain neuroreceptors of SPF BALB/c mice as distinct from the wild-type parental pFira VZV variant and vOka VZV vaccine strains (USA); the absent neurotropism of Russian vFiraVax VZV and vZelVax HZ vaccine strains is not connected with the decreased immunogenicity in relation to foreign counterparts; the electron microscope study of the vFiraVax VZV virus containing liquid concentrate detected VZV nucleocapsids.Conclusion. The differences in the VZV ability to bind to preparations of brain membrane receptors of SPF BALB/c mice can be explained by the differences in the technology of vaccine manufacturing, including attenuation techniques, obtaining of the vaccine strain, specific characteristics of the latent parental lpZel HZ virus. The absence of the binding with brain neuroreceptors of SPF mice has been proved for the Russian vFiraVax VZV and vZelVax HZ vaccine strains which was is not connected with a decrease in their immunogenicity. The method of assessment of the binding ability of VZV vaccine strains can be used as a preliminary characteristic of neurotropism for newly created vaccine strains and for vaccine products.

Spontaneous reports of primarily suspected herbal hepatotoxicity by Pelargonium sidoides: Was causality adequately ascertained?

Spontaneous reports of primarily assumed hepatotoxicity in connection with the use of Pelargonium sidoides (PS) have been interpreted by the Drug Commission of the German Medical Association (DCGMA) as showing some hepatotoxic potential of PS used to treat common cold and other respiratory tract infections. Causality for PS was assessed using the liver specific, structured, quantitative, and updated scale of the Council for International Organizations of Medical Sciences (CIOMS). In none of the 15 cases was there a highly probable or probable causality for PS. Analysis revealed confounding factors such as numerous final diagnoses unrelated to PS and poor data quality in virtually all cases. In only a minority of the cases were data provided to consider even common other diseases of the liver. For instance, biliary tract imaging data were available in only 3 patients; data to exclude virus infections by hepatitis A–C were provided in 4 cases and by CMV and EBV in 1 case, whereas HSV and VZV virus infections remained unconsidered. Thus, convincing evidence is lacking that PS was a potential hepatotoxin in the analyzed cases.

Encéphalites infectieuses : données et limites du PMSI pour l'étude épidémiologique, France métropolitaine 2000–2002

Many virus and bacteria can cause encephalitis but are rarely identified as the aetiological agent by individual diagnosis. In France, the only continuous source of information about encephalitis is the national hospital medical database (NHMD). Data from the VIH-negative patients recorded in mainland France between 2000 and 2002 with a diagnosis of encephalitis were extracted and analysed according to demographic, geographical and temporal distribution. Hospitalisation details were described. An average of 1200 patients was recorded each year. They were residents of all French districts and equally hospitalized in university hospitals and non university hospitals. Their mean age was 38, and most were men. The aetiological diagnosis was unknown for 80%. The most frequent aetiological diagnosis was herpes simplex virus in adults, and VZV virus in children. These results give us some clues to design a national study on encephalitis. The study will be implemented in mainland France in 2007 and will last one year. We invite all voluntary hospitals to include their encephalitic patients in our study.

The recurrent aphthous stomatitis' healing duration differences in female students between the sufferer and non sufferer of chicken pox

Chicken pox (CP) is a generalized primary infection that occurs the first time an individual contacts the virus. The etiology of CP is a VZV virus, and the replication of virus allowing recovery in two to three weeks. During the process, the VZV may progress along sensory nerves to the sensory ganglia, where it can reside in a latent, undetectable form; and can be reactivated at any time. Recurrent aphthous stomatitis (RAS) is a recurrent ulcer in the mouth, painful, disturbing the mouth's function and esthetic when occurs in the lips. One of the etiology of RAS is the reactivation of the latent virus in the mouth. The aim of this study was to know the contribution of the latent virus in the ganglia, intervered with the differences of the healing duration of RAS in female students, between the CP sufferer and non CP sufferer. By cross-sectionally, clinical examination, after filling the questioner that included informed consent, 307 students of The St. Yusup Senior High School, Karangpilang Surabaya, were examined. In the 3 rd class, there were only 6 female students that suffered RAS had CP history, while 11, student did not. Levene's test for equality of variances was done, and p: 0.698, while 2-tail sign: 0.512. According to this statistical analysis, there was no significant difference between the two groups examined. It was suggested that the female students of RAS' sufferer should maintain their balanced food intake, so the ulcer of RAS would heal quickly.