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Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

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Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
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Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Arboviral Encephalitis01:25

Arboviral Encephalitis

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Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
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Cytomegalovirus Disease01:27

Cytomegalovirus Disease

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Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
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Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

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Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Chronic herpes simplex virus type 2 encephalitis associated with posterior uveitis.

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Chronic herpes simplex virus-2 (HSV-2) encephalitis can present with posterior uveitis. Early diagnosis and treatment with acyclovir improved cognitive function and cured the uveitis in one patient.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Infectious Diseases

Background:

  • Herpes simplex virus-2 (HSV-2) is a common cause of recurrent genital herpes.
  • HSV-2 can cause neurological complications, including encephalitis, particularly in immunocompromised individuals.
  • Chronic or recurrent posterior uveitis is a known manifestation of HSV-2 infection.

Observation:

  • A 66-year-old immunocompetent man presented with refractory posterior uveitis and subsequent cognitive decline.
  • Brain MRI revealed hyperintense lesions, and CSF analysis showed pleocytosis and elevated protein.
  • Quantitative PCR detected HSV-2 DNA in the cerebrospinal fluid.

Findings:

  • The patient was diagnosed with chronic HSV-2 encephalitis concomitant with posterior uveitis.
  • Treatment with acyclovir led to gradual cognitive improvement and complete resolution of posterior uveitis.
  • HSV-2 DNA was confirmed in the cerebrospinal fluid, establishing the causative agent.

Implications:

  • Clinicians should consider HSV-2 in the differential diagnosis of chronic encephalitis in immunocompetent patients.
  • Posterior uveitis may serve as an important associated clinical feature of HSV-2 encephalitis.
  • Prompt diagnosis and antiviral therapy are crucial for managing HSV-2 encephalitis and associated ocular manifestations.