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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
[Respiratory syncytial virus brainstem encephalitis in a 7-year-old boy]
C Tison-Chambellan1, E Cheuret, C Cances
1Service de neuropédiatrie, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse, France. tison.c@chu-toulouse.fr
Insights
Respiratory syncytial virus (RSV) can cause serious neurological complications in children, including encephalitis. This case highlights brainstem encephalitis in a child with RSV, emphasizing the need for further investigation into RSV
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Viral Encephalitis
Background:
- Neurological complications of respiratory syncytial virus (RSV) in children range from 1-40% of cases.
- Common complications include central apnea, anoxia, ischemic brain damage, and seizures.
- Encephalitis is a rare but severe neurological manifestation of RSV infection.
Observation:
- A 7-year-old boy presented with RSV A nasopharyngitis and subsequent brainstem encephalitis.
- Cerebrospinal fluid analysis revealed positive polymerase chain reaction for RSV, indicating viral replication.
- Magnetic resonance imaging (MRI) showed abnormalities consistent with encephalitis.
Findings:
- The case demonstrates viral replication encephalitis as a cause of brainstem encephalitis in a pediatric RSV infection.
- Literature review indicates that neurological complications of RSV are not fully investigated, with limited reports on encephalitis.
- Central apnea, a frequent RSV complication, may have a peripheral mechanism, as suggested by animal studies.
Implications:
- This case underscores the potential for RSV to cause severe central nervous system infections in children.
- Further research is needed to elucidate the pathophysiology and epidemiology of RSV-induced neurological complications, particularly encephalitis.
- Understanding these mechanisms is crucial for timely diagnosis and effective management of pediatric RSV infections.
Abstract:
The literature reports that neurological complications of childhood respiratory diseases due to respiratory syncytial virus (RSV) fluctuate between 1 and 40% of cases. They mostly involve central apnea - often the first symptom of infection - anoxia, and ischemic brain damage due to severe sudden weakness in infants, and seizures and consciousness disorders more or less associated with focalized neurological deficiency proving an encephalitis lesion. We report the case of brainstem encephalitis in a 7-year-old boy with RSV A nasopharyngitis, with meningitis, positive polymerase chain reaction in cerebrospinal fluid and magnetic resonance imaging (MRI) abnormalities, which was explained by viral replication encephalitis. Based on a literature review, we discuss the main aspects of epidemiology and physiopathology of the main neurological complication of RSV. Most of them have not been fully investigated and only a few articles report encephalitis. As far as central apnea is concerned, an animal experimental hypothesis surprisingly suggests a peripheral mechanism.
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