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[Echovirus encephalitis during Bruton disease. Favorable development. Therapeutic problems]
Archives Francaises De Pediatrie
|June 1, 1979
Summary
A boy with agammaglobulinaemia experienced encephalitis due to Echo virus. Treatment with gammaglobulin led to clinical improvement, though complete cure remains uncertain.
Area of Science:
- Pediatric Neurology
- Immunology
- Virology
Background:
- Bruton type agammaglobulinaemia is a primary immunodeficiency characterized by a severe lack of B cells and antibodies.
- Patients with agammaglobulinaemia are susceptible to recurrent sinopulmonary infections and other opportunistic infections.
- Viral encephalitis can be a severe complication in immunocompromised individuals.
Observation:
- A 16-year-old male with Bruton type agammaglobulinaemia presented with acute encephalitis.
- Echo virus type 3 was identified in cerebrospinal fluid (CSF) samples on two separate occasions.
- The patient received both intramuscular and intrathecal gammaglobulin therapy with high anti-Echo virus titers.
Findings:
- Clinical improvement was observed following gammaglobulin administration.
- Cerebrospinal fluid protein levels remained elevated post-treatment, indicating persistent inflammation.
- The specific viral agent identified was Echo virus type 3.
Implications:
- This case highlights the potential for severe viral infections, including Echo virus encephalitis, in patients with primary immunodeficiencies like agammaglobulinaemia.
- Gammaglobulin therapy, particularly with high specific antibody titers, may be beneficial in managing such infections.
- The persistent elevation in CSF protein suggests the need for ongoing monitoring and potentially further therapeutic interventions to ensure complete resolution of the encephalitis.