Japanese encephalitis(JE),a vector-borne disease caused by the Japanese encephalitis virus(JEV),remains a major public health concern in South and Southeast Asia[1].JEV,a Flaviviridae family virus,is primarily transmi...Japanese encephalitis(JE),a vector-borne disease caused by the Japanese encephalitis virus(JEV),remains a major public health concern in South and Southeast Asia[1].JEV,a Flaviviridae family virus,is primarily transmitted by Culex mosquitoes,especially the Culex vishnui subgroup,which breeds extensively in rice fields[1].Birds(Ardeidae family)act as natural reservoirs,while pigs serve as amplifying hosts,and humans are incidental hosts[1].展开更多
BACKGROUND Paraneoplastic limbic encephalitis(LE)is an inflammatory condition that affects the limbic system,cerebellum,and peripheral nervous system.It causes a range of symptoms including short-term memory loss,impa...BACKGROUND Paraneoplastic limbic encephalitis(LE)is an inflammatory condition that affects the limbic system,cerebellum,and peripheral nervous system.It causes a range of symptoms including short-term memory loss,impaired cognitive function,behavioral and psychological disorders,and seizures.Paraneoplastic LE can occur when an immune response is activated due to antibodies targeting gammaaminobutyric acid(GABA)B receptor(GABABR)interacting with antigens on tumor cells and the nervous system,resulting in tumors primarily as small cell lung carcinoma(SCLC).CASE SUMMARY We discuss two cases of GABABR antibody-related LE resulting from SCLC.The patients’symptoms were managed with immunotherapy but ended in premature death due to chemotherapy-related complications.CONCLUSION Paraneoplastic syndrome is a notable cause of LE.Early intravenous immunoglobulin therapy may lead to temporary remission.展开更多
The Japanese encephalitis virus(JEV)causes Japanese encephalitis(JE),a severe disease that primarily affects children and induces significant central nervous system complications.With the widespread adoption of vaccin...The Japanese encephalitis virus(JEV)causes Japanese encephalitis(JE),a severe disease that primarily affects children and induces significant central nervous system complications.With the widespread adoption of vaccination in children,the incidence among older individuals has increased substantially.Despite this epidemiological shift,research on JEV infection in the elderly remains limited.We established JEV infection models using both aged and young mice to explore age-related differences in pathology and underlying mechanisms.Brain tissue samples were analyzed for pathological changes and viral tropism in major cell types.To further characterize immune response variations,we conducted transcriptomic sequencing on the brain tissues following JEV infection.Aged mice exhibited lower mortality,delayed disease progression,and milder brain pathology compared to young mice after JEV infection.Viral titers and infection rates of major brain cell types were similar in both groups.Transcriptomic analysis revealed diminished immune activation and weaker inflammatory responses in aged mice.Additionally,microglial activation and CD8^(+) T cell function were significantly reduced.Interestingly,JEV infection induced the selective recruitment of B cells in the brains of aged mice.These B cells may modulate the effects of CD8^(+) T cells in the disease process.Compared to young mice,aged mice showed enhanced resistance to JEV progression and reduced brain pathology.This resistance was associated with a weakened immune response in the aged brain,rather than differences in viral infection.The specific recruitment of B cells in the brains of aged mice may play a crucial role in limiting disease progression.展开更多
Tick-borne encephalitis virus(TBEV)is a re-emerging pathogen in Kazakhstan,where the increasing risk of its spread underscores the need for improved healthcare preparedness,including the development of local vaccines....Tick-borne encephalitis virus(TBEV)is a re-emerging pathogen in Kazakhstan,where the increasing risk of its spread underscores the need for improved healthcare preparedness,including the development of local vaccines.However,the absence of reference TBEV strains in the country presented a major challenge.To address this,we generated a prototype strain(Vasilchenko)of the Siberian TBEV genotype,predominant in Kazakhstan,using synthetic genome and molecular infectious clone technology.A DNA-launched TBEV molecular clone was assembled from DNA fragments,enabling virus rescue upon plasmid transfection.During the propagation of the post-transfection virus in cell culture,a single amino acid substitution(E51K)in the envelope protein emerged,resulting in a 100-fold increase in the titer of the mutant variant.In vivo,this mutation significantly attenuated virulence:while wild-type TBEV caused 100%mortality in BALB/c mice,the E51K variant was non-lethal and exhibited reduced viremia,suggesting impaired neuroinvasiveness.To further exploit this attenuated,high-titer virus,we developed a GFP-expressing reporter TBEV variant.Using this reporter system,we demonstrated that favipiravir possesses antiviral activity against TBEV,with inhibitory concentrations within a pharmacologically relevant range.In conclusion,synthetic genomics enabled the generation of a reference TBEV strain to replenish Kazakhstan's collections.The E51K mutation enhances viral replication in vitro while attenuating pathogenicity in vivo,and the derived reporter virus is suitable for antiviral compound screening.展开更多
Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional seve...Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional severe manifestations like meningoencephalitis and myocarditis.展开更多
Addressing the challenges of difficult early diagnosis and the incomplete prognosis evaluation system for Autoimmune Encephalitis(AE),this study comprehensively reviews the relevant indicators for early diagnosis and ...Addressing the challenges of difficult early diagnosis and the incomplete prognosis evaluation system for Autoimmune Encephalitis(AE),this study comprehensively reviews the relevant indicators for early diagnosis and prognosis evaluation of AE.The analysis reveals that multiple indicators currently exhibit unique value in the diagnosis and treatment of AE,but each has its limitations.This article aims to systematically review these indicators and clarify their current application in clinical practice,to help improve the accuracy of early diagnosis and prognosis evaluation of AE,and provide a theoretical basis for clinicians to develop more effective treatment strategies.展开更多
Objective:To explore the application effect of bundle management in the safe nursing of patients with autoimmune encephalitis.Methods:Seventy-five patients with autoimmune encephalitis who met the inclusion criteria i...Objective:To explore the application effect of bundle management in the safe nursing of patients with autoimmune encephalitis.Methods:Seventy-five patients with autoimmune encephalitis who met the inclusion criteria in our hospital from January 2024 to June 2024 were randomly divided into two groups:an observation group of 39 patients and a control group of 36 patients.The control group received routine nursing care,while the observation group implemented a bundle management strategy based on routine nursing care.Safety nursing outcomes,clinical symptom improvement time,hospital stay,and neurologic function recovery were observed in both groups.Results:The incidence of adverse events in the observation group was 12.82%,significantly lower than the 33.33%in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in restraint usage and ICU transfer rates between the two groups(P>0.05).The clinical symptom improvement time,hospital stay,and neurologic function recovery in the observation group were significantly better than those in the control group,with a statistically significant difference(P<0.05).Conclusion:Through the bundle management model,effective connections can be ensured in various aspects of treatment and rehabilitation for patients with autoimmune encephalitis,providing patients with comprehensive and multi-level nursing services and improving their overall satisfaction and treatment effectiveness.展开更多
Candida albicans(C.abicans),вcommon pathogenic fungus in nature,has enough cæpity to cause Severe brain infection through various mesns under immunocompromised conditions.Currently,stablishing a basic animal dis...Candida albicans(C.abicans),вcommon pathogenic fungus in nature,has enough cæpity to cause Severe brain infection through various mesns under immunocompromised conditions.Currently,stablishing a basic animal disesse model has become the main rsrch tool,which isconducive to simulat ing fungal encephalitis effectively.However,the widely used bloodbarne infection model established by intravenoOus(I.V)injection in mice usually results in systenic infecions but cannot simulate significant bradn inflammation.Here,we developed&fungal en-cephaltis model by intracerebroventriaular(L.C.V)injection af C.albicansto better simulate the significant harm und consequencEs.Compared with I.V,a greater number of colony-for ming units(CFUa)in the brain was induced following I.CV.Magnetic resonane imaging MRM resulta revesled more obvious inflammatinn in the external capsule area of the brain.Menwhile,be havioral experiments with the Y-meze also indicated that abnormal activity behavior further relected significant short-term mamory impairment after I.C.Vof C.albicans.In summary,these studies not onby provide a novel fungal encephalitis model for understanding the pathogenesis mechanism of this disease but also lay a solid foundation for future effective tretment.展开更多
Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mecha...Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mechanism of pathogenesis remains incompletely understood,but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways.Young adults are most frequently affected;the median age at diagnosis is 21 years.There is a strong female predilection with a female sex predominance of 4:1.NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma.However,NMDARE has also been described in patients with small cell lung cancer,clear cell renal carcinoma,and other benign and malignant neoplasms.Diagnosis is based on correlation of the clinical presentation,electro-encephalography,laboratory studies,and imaging.Computed tomography,positron emission tomography,and magnetic resonance imaging are essential to identify an underlying tumor,exclude clinicopathologic mimics,and predict the likelihood of long-term functional impairment.Nuclear imaging may be of value for prognostication and to assess the response to therapy.Treatment may involve high-dose corticosteroids,intravenous immunoglobulin,and plasma exchange.Herein,we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria,treatment regimens,and proposed pathogenetic mechanisms.展开更多
Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompe...Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompetent individuals. We present the case of a young adult patient without immunocompromise, who developed meningoencephalitis due to L. monocytogenes;This case is exceptional, since it occurred in an individual outside the classic age group, in addition to not having risk factors, which is why it should be considered an atypical causal agent.展开更多
Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laborat...Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laboratory diagnosis of viral encephalitis is a worldwide challenge.Recently,high-throughput sequencing technology has provided new tools for diagnosing central nervous system infections.Thus,In this study,we established a multipathogen detection platform for viral encephalitis based on amplicon sequencing.Methods We designed nine pairs of specific polymerase chain reaction(PCR)primers for the 12 viruses by reviewing the relevant literature.The detection ability of the primers was verified by software simulation and the detection of known positive samples.Amplicon sequencing was used to validate the samples,and consistency was compared with Sanger sequencing.Results The results showed that the target sequences of various pathogens were obtained at a coverage depth level greater than 20×,and the sequence lengths were consistent with the sizes of the predicted amplicons.The sequences were verified using the National Center for Biotechnology Information BLAST,and all results were consistent with the results of Sanger sequencing.Conclusion Amplicon-based high-throughput sequencing technology is feasible as a supplementary method for the pathogenic detection of viral encephalitis.It is also a useful tool for the high-volume screening of clinical samples.展开更多
Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Sy...Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.展开更多
Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe vira...Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group(n=37)and the reference group(n=37).Targeted nursing was given to the target group,while general nursing was given to the reference group.Physical rehabilitation,motor scores,and lung function were compared between the groups.Results:The recovery time of limb abnormalities,convulsions,abnormal consciousness,and cranial nerve disorders in the target group was significantly better than that in the reference group(P<0.05).The motor function,joint activity and pain,sensory function,and total score of the target group were significantly lower than those of the reference group(P<0.05).After the intervention,lung function indicators including VC(vital capacity),FVC(forced vital capacity),and MVV(maximum voluntary ventilation)of the target group were better than those of the reference group(P<0.05).Conclusion:Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children,speed up the recovery of motor function,and improve lung function.This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.展开更多
Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases a...Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases and attempted to elucidate which JEV genotype was most closely related to human Japanese encephalitis(JE)in the coastal provinces of China.Methods In this study,we collected serum specimens from patients with JE in three coastal provinces of China(Guangdong,Zhejiang,and Shandong)from 2018 to 2020 and conducted JEV cross-neutralization tests against G1,G3,and G5.Results Acute serum specimens from clinically reported JE cases were obtained for laboratory confirmation from hospitals in Shandong(92 patients),Zhejiang(192 patients),and Guangdong(77 patients),China,from 2018 to 2020.Seventy of the 361 serum specimens were laboratory-confirmed to be infected with JEV.Two cases were confirmed to be infected with G1 JEV,32 with G3 JEV,and two with G5 JEV.Conclusion G3 was the primary infection genotype among JE cases with a definite infection genotype,and the infection caused by G5 JEV was confirmed serologically in China.展开更多
Autoimmune encephalitis(AE)is a type of encephalitis caused by autoimmune disease.AE was included on a list of the first batch of 121 rare diseases published by the Chinese National Health Commission on 11^(th)May 201...Autoimmune encephalitis(AE)is a type of encephalitis caused by autoimmune disease.AE was included on a list of the first batch of 121 rare diseases published by the Chinese National Health Commission on 11^(th)May 2018.Currently,patients with AE account for 10%-20% of encephalitis cases,with 54%-80% of those cases classified as the anti-N-methyl-D-aspartate receptor(NMDAR)type,which is the most common type.[1]In 2010,China reported the first case of a patient withanti-NMDARtype AE.展开更多
BACKGROUND Anti-contactin-associated protein-like 2(CASPR2)antibody encephalitis is an autoimmune disorder characterized by the presence of antibodies against the voltage-gated potassium channel.This leads to neurolog...BACKGROUND Anti-contactin-associated protein-like 2(CASPR2)antibody encephalitis is an autoimmune disorder characterized by the presence of antibodies against the voltage-gated potassium channel.This leads to neurological symptoms,such as seizures,cognitive decline,and neuropathic pain,primarily affecting the limbic system.The prognosis of this disorder varies among individuals.CASE SUMMARY The patient,a girl aged nine years and nine months,underwent treatment for 14 to 21 d.The main clinical manifestations were vomiting and unclear consciousness,positive pathological signs,normal cranial computed tomography and magnetic resonance imaging,and abnormal electroencephalogram.The child was discharged after receiving immunoglobulin and hormone treatment.Subsequent follow-up over a period of 15 months after discharge,conducted through telephone and outpatient visits,showed no recurrence of symptoms.CONCLUSION Anti-CASPR2 antibody autoimmune encephalitis in children is rare,mainly manifested as convulsions,mental abnormalities,cognitive impairment,and neuropathic pain,among others.Timely evaluation for autoimmune encephalitis antibodies is crucial,especially in cases of recurrent central nervous system involvement in children.展开更多
Rationale:Transmitted to humans via the Aedes mosquito,Chikungunya virus(CHIKV)is associated with multi-system complications,sometimes collectively referred to as“atypical features.”However,a disorder of the nervous...Rationale:Transmitted to humans via the Aedes mosquito,Chikungunya virus(CHIKV)is associated with multi-system complications,sometimes collectively referred to as“atypical features.”However,a disorder of the nervous system appears to be the most common severe complication of CHIKV infection.Patient’s Concern:A seventy-five-year-old patient from India presented to the hospital with fever,chills,rigors,and multiple joint pains for which he was worked up.Diagnosis:CHIKV encephalitis.Interventions:The patient was treated initially on supportive therapy with antipyretics,intravenous fluids;however,during his hospital stay,the patient had altered sensorium during which he was managed in the intensive care unit;required mechanical ventilation.Outcomes:The patient sccumbed to his illness.Lessons:Treating clinicians should keep CHIKV disease in the differential diagnosis in cases of febrile exanthems associated with disabling arthritis,especially in a CHIKV-endemic country like India.展开更多
Introduction: Herpes simplex virus is the most common etiology for life-threatening sporadic encephalitis worldwide. Antiviral therapy with acyclovir has been shown to reduce mortality and should be started promptly i...Introduction: Herpes simplex virus is the most common etiology for life-threatening sporadic encephalitis worldwide. Antiviral therapy with acyclovir has been shown to reduce mortality and should be started promptly in patients with clinically suspected viral encephalitis before serological confirmation of the diagnosis. Despite antiviral treatment, it is associated with significant mortality and a wide range of neurologic sequelae or neuropsychiatric disorders. Clinical presentation includes fever, headache, altered mental status, and focal or generalized seizures. In some cases, it can present with focal neurological deficits, such as an acute stroke. The aim of this study is to identify rare complications of HSVE. Presentation: We present a case of a 71-year-old female patient with herpes virus encephalitis and an ischemic cerebral accident. The findings of CT scan of the brain revealed an extensive right temporal hypodensity. CSF findings include an elevated protein level, normal glucose level and pleocytosis with lymphocyte predominance. The lumbar tap confirmed the presence of herpes simplex virus type 1 with polymerase chain reaction (PCR) in the CSF. Neurological manifestations include focal neurological deficit with left-sided hemiparesis and coma. After 40 days of complex therapy, an improvement in the mental state was observed. Conclusion: There are varying degrees of neurologic sequelae among survivors in children and adults despite the antiviral treatment. Herpes simplex encephalitis has significant morbidity and high mortality due to the lack of prophylactic treatment and preventable strategies.展开更多
Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms an...Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms and respiratory decline were finally explained by the diagnosis of West Nile-encephalitis. During her admission, the isolated peaked T-waves indicated the underlying stress-induced cardiomyopathy. The absence of all other causes of hyperacute T-waves, their subsequent resolution with the resolution of infection and improvement in wall motion abnormalities, further supported the association. This case highlights the importance of considering hyperacute T-waves in an approach towards the diagnosis of WNV-encephalitis related atypical variant of stress-induced cardiomyopathy.展开更多
Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty...Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.展开更多
文摘Japanese encephalitis(JE),a vector-borne disease caused by the Japanese encephalitis virus(JEV),remains a major public health concern in South and Southeast Asia[1].JEV,a Flaviviridae family virus,is primarily transmitted by Culex mosquitoes,especially the Culex vishnui subgroup,which breeds extensively in rice fields[1].Birds(Ardeidae family)act as natural reservoirs,while pigs serve as amplifying hosts,and humans are incidental hosts[1].
文摘BACKGROUND Paraneoplastic limbic encephalitis(LE)is an inflammatory condition that affects the limbic system,cerebellum,and peripheral nervous system.It causes a range of symptoms including short-term memory loss,impaired cognitive function,behavioral and psychological disorders,and seizures.Paraneoplastic LE can occur when an immune response is activated due to antibodies targeting gammaaminobutyric acid(GABA)B receptor(GABABR)interacting with antigens on tumor cells and the nervous system,resulting in tumors primarily as small cell lung carcinoma(SCLC).CASE SUMMARY We discuss two cases of GABABR antibody-related LE resulting from SCLC.The patients’symptoms were managed with immunotherapy but ended in premature death due to chemotherapy-related complications.CONCLUSION Paraneoplastic syndrome is a notable cause of LE.Early intravenous immunoglobulin therapy may lead to temporary remission.
基金the National Natural Science Foundation of China(82172266to P.G.W.)Natural Science Foundation of Beijing(7232002 to N.G.).
文摘The Japanese encephalitis virus(JEV)causes Japanese encephalitis(JE),a severe disease that primarily affects children and induces significant central nervous system complications.With the widespread adoption of vaccination in children,the incidence among older individuals has increased substantially.Despite this epidemiological shift,research on JEV infection in the elderly remains limited.We established JEV infection models using both aged and young mice to explore age-related differences in pathology and underlying mechanisms.Brain tissue samples were analyzed for pathological changes and viral tropism in major cell types.To further characterize immune response variations,we conducted transcriptomic sequencing on the brain tissues following JEV infection.Aged mice exhibited lower mortality,delayed disease progression,and milder brain pathology compared to young mice after JEV infection.Viral titers and infection rates of major brain cell types were similar in both groups.Transcriptomic analysis revealed diminished immune activation and weaker inflammatory responses in aged mice.Additionally,microglial activation and CD8^(+) T cell function were significantly reduced.Interestingly,JEV infection induced the selective recruitment of B cells in the brains of aged mice.These B cells may modulate the effects of CD8^(+) T cells in the disease process.Compared to young mice,aged mice showed enhanced resistance to JEV progression and reduced brain pathology.This resistance was associated with a weakened immune response in the aged brain,rather than differences in viral infection.The specific recruitment of B cells in the brains of aged mice may play a crucial role in limiting disease progression.
基金supported by funds from the scientific and technical program BR218004/0223“Improving measures to ensure biological safety in Kazakhstan:counteracting dangerous and especially dangerous infections”.Part of this work carried out in Russian Federation was supported by internal grant funding from the Scientific Centre for Family Health and Human Reproduction Problems:grant number 121022500179-0.Title:“Molecular,Organismal,and Population Patterns of the Epidemic Process of Anthropozoonotic and Transmissible Infections in the Territory of Northern Asia and Adjacent Areas".
文摘Tick-borne encephalitis virus(TBEV)is a re-emerging pathogen in Kazakhstan,where the increasing risk of its spread underscores the need for improved healthcare preparedness,including the development of local vaccines.However,the absence of reference TBEV strains in the country presented a major challenge.To address this,we generated a prototype strain(Vasilchenko)of the Siberian TBEV genotype,predominant in Kazakhstan,using synthetic genome and molecular infectious clone technology.A DNA-launched TBEV molecular clone was assembled from DNA fragments,enabling virus rescue upon plasmid transfection.During the propagation of the post-transfection virus in cell culture,a single amino acid substitution(E51K)in the envelope protein emerged,resulting in a 100-fold increase in the titer of the mutant variant.In vivo,this mutation significantly attenuated virulence:while wild-type TBEV caused 100%mortality in BALB/c mice,the E51K variant was non-lethal and exhibited reduced viremia,suggesting impaired neuroinvasiveness.To further exploit this attenuated,high-titer virus,we developed a GFP-expressing reporter TBEV variant.Using this reporter system,we demonstrated that favipiravir possesses antiviral activity against TBEV,with inhibitory concentrations within a pharmacologically relevant range.In conclusion,synthetic genomics enabled the generation of a reference TBEV strain to replenish Kazakhstan's collections.The E51K mutation enhances viral replication in vitro while attenuating pathogenicity in vivo,and the derived reporter virus is suitable for antiviral compound screening.
文摘Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional severe manifestations like meningoencephalitis and myocarditis.
文摘Addressing the challenges of difficult early diagnosis and the incomplete prognosis evaluation system for Autoimmune Encephalitis(AE),this study comprehensively reviews the relevant indicators for early diagnosis and prognosis evaluation of AE.The analysis reveals that multiple indicators currently exhibit unique value in the diagnosis and treatment of AE,but each has its limitations.This article aims to systematically review these indicators and clarify their current application in clinical practice,to help improve the accuracy of early diagnosis and prognosis evaluation of AE,and provide a theoretical basis for clinicians to develop more effective treatment strategies.
文摘Objective:To explore the application effect of bundle management in the safe nursing of patients with autoimmune encephalitis.Methods:Seventy-five patients with autoimmune encephalitis who met the inclusion criteria in our hospital from January 2024 to June 2024 were randomly divided into two groups:an observation group of 39 patients and a control group of 36 patients.The control group received routine nursing care,while the observation group implemented a bundle management strategy based on routine nursing care.Safety nursing outcomes,clinical symptom improvement time,hospital stay,and neurologic function recovery were observed in both groups.Results:The incidence of adverse events in the observation group was 12.82%,significantly lower than the 33.33%in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in restraint usage and ICU transfer rates between the two groups(P>0.05).The clinical symptom improvement time,hospital stay,and neurologic function recovery in the observation group were significantly better than those in the control group,with a statistically significant difference(P<0.05).Conclusion:Through the bundle management model,effective connections can be ensured in various aspects of treatment and rehabilitation for patients with autoimmune encephalitis,providing patients with comprehensive and multi-level nursing services and improving their overall satisfaction and treatment effectiveness.
基金financially supported by the ResearchInitiation Ftnd Project at Hainan University(Grant Nos.KYQD(ZR)20078 and KYQD(ZR)23179).
文摘Candida albicans(C.abicans),вcommon pathogenic fungus in nature,has enough cæpity to cause Severe brain infection through various mesns under immunocompromised conditions.Currently,stablishing a basic animal disesse model has become the main rsrch tool,which isconducive to simulat ing fungal encephalitis effectively.However,the widely used bloodbarne infection model established by intravenoOus(I.V)injection in mice usually results in systenic infecions but cannot simulate significant bradn inflammation.Here,we developed&fungal en-cephaltis model by intracerebroventriaular(L.C.V)injection af C.albicansto better simulate the significant harm und consequencEs.Compared with I.V,a greater number of colony-for ming units(CFUa)in the brain was induced following I.CV.Magnetic resonane imaging MRM resulta revesled more obvious inflammatinn in the external capsule area of the brain.Menwhile,be havioral experiments with the Y-meze also indicated that abnormal activity behavior further relected significant short-term mamory impairment after I.C.Vof C.albicans.In summary,these studies not onby provide a novel fungal encephalitis model for understanding the pathogenesis mechanism of this disease but also lay a solid foundation for future effective tretment.
文摘Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mechanism of pathogenesis remains incompletely understood,but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways.Young adults are most frequently affected;the median age at diagnosis is 21 years.There is a strong female predilection with a female sex predominance of 4:1.NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma.However,NMDARE has also been described in patients with small cell lung cancer,clear cell renal carcinoma,and other benign and malignant neoplasms.Diagnosis is based on correlation of the clinical presentation,electro-encephalography,laboratory studies,and imaging.Computed tomography,positron emission tomography,and magnetic resonance imaging are essential to identify an underlying tumor,exclude clinicopathologic mimics,and predict the likelihood of long-term functional impairment.Nuclear imaging may be of value for prognostication and to assess the response to therapy.Treatment may involve high-dose corticosteroids,intravenous immunoglobulin,and plasma exchange.Herein,we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria,treatment regimens,and proposed pathogenetic mechanisms.
文摘Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompetent individuals. We present the case of a young adult patient without immunocompromise, who developed meningoencephalitis due to L. monocytogenes;This case is exceptional, since it occurred in an individual outside the classic age group, in addition to not having risk factors, which is why it should be considered an atypical causal agent.
基金supported by the National Key Research and Development Program(grant number:2022YFC2305304).
文摘Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laboratory diagnosis of viral encephalitis is a worldwide challenge.Recently,high-throughput sequencing technology has provided new tools for diagnosing central nervous system infections.Thus,In this study,we established a multipathogen detection platform for viral encephalitis based on amplicon sequencing.Methods We designed nine pairs of specific polymerase chain reaction(PCR)primers for the 12 viruses by reviewing the relevant literature.The detection ability of the primers was verified by software simulation and the detection of known positive samples.Amplicon sequencing was used to validate the samples,and consistency was compared with Sanger sequencing.Results The results showed that the target sequences of various pathogens were obtained at a coverage depth level greater than 20×,and the sequence lengths were consistent with the sizes of the predicted amplicons.The sequences were verified using the National Center for Biotechnology Information BLAST,and all results were consistent with the results of Sanger sequencing.Conclusion Amplicon-based high-throughput sequencing technology is feasible as a supplementary method for the pathogenic detection of viral encephalitis.It is also a useful tool for the high-volume screening of clinical samples.
文摘Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.
文摘Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group(n=37)and the reference group(n=37).Targeted nursing was given to the target group,while general nursing was given to the reference group.Physical rehabilitation,motor scores,and lung function were compared between the groups.Results:The recovery time of limb abnormalities,convulsions,abnormal consciousness,and cranial nerve disorders in the target group was significantly better than that in the reference group(P<0.05).The motor function,joint activity and pain,sensory function,and total score of the target group were significantly lower than those of the reference group(P<0.05).After the intervention,lung function indicators including VC(vital capacity),FVC(forced vital capacity),and MVV(maximum voluntary ventilation)of the target group were better than those of the reference group(P<0.05).Conclusion:Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children,speed up the recovery of motor function,and improve lung function.This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.
基金supported by the National Key Research and Development Program[2022YFC2302700].
文摘Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases and attempted to elucidate which JEV genotype was most closely related to human Japanese encephalitis(JE)in the coastal provinces of China.Methods In this study,we collected serum specimens from patients with JE in three coastal provinces of China(Guangdong,Zhejiang,and Shandong)from 2018 to 2020 and conducted JEV cross-neutralization tests against G1,G3,and G5.Results Acute serum specimens from clinically reported JE cases were obtained for laboratory confirmation from hospitals in Shandong(92 patients),Zhejiang(192 patients),and Guangdong(77 patients),China,from 2018 to 2020.Seventy of the 361 serum specimens were laboratory-confirmed to be infected with JEV.Two cases were confirmed to be infected with G1 JEV,32 with G3 JEV,and two with G5 JEV.Conclusion G3 was the primary infection genotype among JE cases with a definite infection genotype,and the infection caused by G5 JEV was confirmed serologically in China.
基金supported by grants from the National Natural Science Foundation of China(81970072 to LXT)the Leading Medical Talent Project of Shanghai Pudong Heath Bureau(PWRI2019-05 to LXT)+3 种基金the Action Plan for Scientific and Technological Innovation of Shanghai Scientific Committee of China(20Y11901200 to LXT)the Municipal Natural Science Foundation of Shanghai Scientific Committee of China(22ZR1451000 to LXT)the Key Clinical Discipline of Shanghai Pudong Heath Bureau(PWZxk2022-17 to LXT)the Clinical Peak Discipline of Shanghai Pudong Heath Bureau(PWYgf2021-03)。
文摘Autoimmune encephalitis(AE)is a type of encephalitis caused by autoimmune disease.AE was included on a list of the first batch of 121 rare diseases published by the Chinese National Health Commission on 11^(th)May 2018.Currently,patients with AE account for 10%-20% of encephalitis cases,with 54%-80% of those cases classified as the anti-N-methyl-D-aspartate receptor(NMDAR)type,which is the most common type.[1]In 2010,China reported the first case of a patient withanti-NMDARtype AE.
文摘BACKGROUND Anti-contactin-associated protein-like 2(CASPR2)antibody encephalitis is an autoimmune disorder characterized by the presence of antibodies against the voltage-gated potassium channel.This leads to neurological symptoms,such as seizures,cognitive decline,and neuropathic pain,primarily affecting the limbic system.The prognosis of this disorder varies among individuals.CASE SUMMARY The patient,a girl aged nine years and nine months,underwent treatment for 14 to 21 d.The main clinical manifestations were vomiting and unclear consciousness,positive pathological signs,normal cranial computed tomography and magnetic resonance imaging,and abnormal electroencephalogram.The child was discharged after receiving immunoglobulin and hormone treatment.Subsequent follow-up over a period of 15 months after discharge,conducted through telephone and outpatient visits,showed no recurrence of symptoms.CONCLUSION Anti-CASPR2 antibody autoimmune encephalitis in children is rare,mainly manifested as convulsions,mental abnormalities,cognitive impairment,and neuropathic pain,among others.Timely evaluation for autoimmune encephalitis antibodies is crucial,especially in cases of recurrent central nervous system involvement in children.
文摘Rationale:Transmitted to humans via the Aedes mosquito,Chikungunya virus(CHIKV)is associated with multi-system complications,sometimes collectively referred to as“atypical features.”However,a disorder of the nervous system appears to be the most common severe complication of CHIKV infection.Patient’s Concern:A seventy-five-year-old patient from India presented to the hospital with fever,chills,rigors,and multiple joint pains for which he was worked up.Diagnosis:CHIKV encephalitis.Interventions:The patient was treated initially on supportive therapy with antipyretics,intravenous fluids;however,during his hospital stay,the patient had altered sensorium during which he was managed in the intensive care unit;required mechanical ventilation.Outcomes:The patient sccumbed to his illness.Lessons:Treating clinicians should keep CHIKV disease in the differential diagnosis in cases of febrile exanthems associated with disabling arthritis,especially in a CHIKV-endemic country like India.
文摘Introduction: Herpes simplex virus is the most common etiology for life-threatening sporadic encephalitis worldwide. Antiviral therapy with acyclovir has been shown to reduce mortality and should be started promptly in patients with clinically suspected viral encephalitis before serological confirmation of the diagnosis. Despite antiviral treatment, it is associated with significant mortality and a wide range of neurologic sequelae or neuropsychiatric disorders. Clinical presentation includes fever, headache, altered mental status, and focal or generalized seizures. In some cases, it can present with focal neurological deficits, such as an acute stroke. The aim of this study is to identify rare complications of HSVE. Presentation: We present a case of a 71-year-old female patient with herpes virus encephalitis and an ischemic cerebral accident. The findings of CT scan of the brain revealed an extensive right temporal hypodensity. CSF findings include an elevated protein level, normal glucose level and pleocytosis with lymphocyte predominance. The lumbar tap confirmed the presence of herpes simplex virus type 1 with polymerase chain reaction (PCR) in the CSF. Neurological manifestations include focal neurological deficit with left-sided hemiparesis and coma. After 40 days of complex therapy, an improvement in the mental state was observed. Conclusion: There are varying degrees of neurologic sequelae among survivors in children and adults despite the antiviral treatment. Herpes simplex encephalitis has significant morbidity and high mortality due to the lack of prophylactic treatment and preventable strategies.
文摘Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms and respiratory decline were finally explained by the diagnosis of West Nile-encephalitis. During her admission, the isolated peaked T-waves indicated the underlying stress-induced cardiomyopathy. The absence of all other causes of hyperacute T-waves, their subsequent resolution with the resolution of infection and improvement in wall motion abnormalities, further supported the association. This case highlights the importance of considering hyperacute T-waves in an approach towards the diagnosis of WNV-encephalitis related atypical variant of stress-induced cardiomyopathy.
文摘Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.
