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European Journal of Clinical Microbiology & Infectious Diseases

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01-11-2021 | Shingles | Brief Report

Characteristics and outcome of varicella-zoster virus central nervous system infections in adults

Authors: A. Le Bot, A. Ballerie, C. Pronier, F. Bénézit, F. Reizine, M. Tas, P. Jégo, M. Revest, Y. Le Tulzo, P. Fillâtre, Pierre Tattevin

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 11/2021

Abstract

We conducted an observational retrospective study of all adults hospitalized for documented varicella-zoster virus (VZV) meningitis or encephalitis during years 2000–2015 in one referral centre. Thirty-six patients (21 males, 15 females) were included, with meningitis (n = 21), or meningoencephalitis (n = 15). Median age was 51 years [interquartile range, 35–76], and 6 patients (17%) were immunocompromised. Aciclovir was started in 32 patients (89%), with a median dose of 11 mg/kg/8 h [10–15]. No patient died, but 12 (33%) had neurological sequelae at discharge. Age was the only variable associated with adverse outcome (OR 1.98 [1.17–3.35] per 10-year increment, P = 0.011).

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Boucher A, Herrmann JL, Morand P, Buzelé R, Crabol Y, Stahl JP et al (2017) Epidemiology of infectious encephalitis causes in 2016. Med Mal Infect 47:221–235. https://doi.org/10.1016/j.medmal.2017.02.003CrossRefPubMed

Grahn A, Studahl M (2015) Varicella-zoster virus infections of the central nervous system–prognosis, diagnostics and treatment. J Inf Secur 71:281–293. https://doi.org/10.1016/j.jinf.2015.06.004CrossRef

Mailles A, Stahl J-P (2009) Steering Committee and Investigators Group. Infectious encephalitis in France in 2007: a national prospective study. Clin Infect Dis 49:1838–1847. https://doi.org/10.1086/648419CrossRefPubMed

Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, Morgan D et al (2010) Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 10:835–844. https://doi.org/10.1016/S1473-3099(10)70222-XCrossRefPubMed

Le Maréchal M, Mailles A, Seigneurin A, Tattevin P, Stahl J-P, Épaulard O (2020) A prospective cohort study to identify clinical, biological and imaging features that predict etiology of acute encephalitis. Clin Infect Dis 20. https://doi.org/10.1093/cid/ciaa598

Stahl JP, Azouvi P, Bruneel F, De Broucker T, Duval X, Fantin B et al (2017) Guidelines on the management of infectious encephalitis in adults. Med Mal Infect 47:179–194. https://doi.org/10.1016/j.medmal.2017.01.005CrossRefPubMed

Chemaly RF, Hill JA, Voigt S, Peggs KS (2019) In vitro comparison of currently available and investigational antiviral agents against pathogenic human double-stranded DNA viruses: a systematic literature review. Antivir Res 163:50–58. https://doi.org/10.1016/j.antiviral.2019.01.008CrossRefPubMed

Venkatesan A, Tunkel AR, Bloch KC, Lauring AS, Sejvar J, Bitnun A et al (2013) Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis 57:1114–1128. https://doi.org/10.1093/cid/cit458CrossRefPubMedPubMedCentral

Reizine F, Pronier C, Lepart C, Grolhier C, Revest M, Thibault V et al (2020) Biphasic evolution of varicella-zoster virus meningoencephalitis: diagnostic challenges. Med Mal Infect 50:87–89. https://doi.org/10.1016/j.medmal.2019.10.016CrossRefPubMed

10.

Tunkel AR, Glaser CA, Bloch KC, Sejvar JJ, Marra CM, Roos KL et al (2008) The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 47:303–327. https://doi.org/10.1086/589747CrossRefPubMed

11.

Klassen TP, Hartling L, Wiebe N, Belseck EM (2005) Acyclovir for treating varicella in otherwise healthy children and adolescents. Cochrane Database Syst Rev 19:CD002980. https://doi.org/10.1002/14651858.CD002980.pub3CrossRef

12.

Whitley RJ, Gnann JW, Hinthorn D, Liu C, Pollard RB, Hayden F et al (1992) Disseminated herpes zoster in the immunocompromised host: a comparative trial of acyclovir and vidarabine. The NIAID Collaborative Antiviral Study Group. J Infect Dis 165:450–455. https://doi.org/10.1093/infdis/165.3.450CrossRefPubMed

13.

Herlin LK, Hansen KS, Bodilsen J, Larsen L, Brandt C, Andersen CØ et al (2020) Varicella zoster virus encephalitis in Denmark from 2015 to 2019-a nationwide prospective cohort study. Clin Infect Dis 27. https://doi.org/10.1093/cid/ciaa185

14.

Parkes-Smith J, Chaudhuri A (2020) Varicella zoster virus: an under-recognised cause of central nervous system infections? Intern Med J 8. https://doi.org/10.1111/imj.15048

15.

Pollak L, Dovrat S, Book M, Mendelson E, Weinberger M (2012) Varicella zoster vs. herpes simplex meningoencephalitis in the PCR era. A single center study. J Neurol Sci 314:29–36. https://doi.org/10.1016/j.jns.2011.11.004CrossRefPubMed

16.

George BP, Schneider EB, Venkatesan A (2014) Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010. PLoS One 9:e104169. https://doi.org/10.1371/journal.pone.0104169CrossRefPubMedPubMedCentral

17.

Erdem H, Cag Y, Ozturk-Engin D, Defres S, Kaya S, Larsen L et al (2015) Results of a multinational study suggest the need for rapid diagnosis and early antiviral treatment at the onset of herpetic meningoencephalitis. Antimicrob Agents Chemother 59:3084–3089. https://doi.org/10.1128/AAC.05016-14CrossRefPubMedPubMedCentral

18.

Mailles A, De Broucker T, Costanzo P, Martinez-Almoyna L, Vaillant V, Stahl J-P et al (2012) Long-term outcome of patients presenting with acute infectious encephalitis of various causes in France. Clin Infect Dis 54:1455–1464. https://doi.org/10.1093/cid/cis226CrossRefPubMed

19.

Singh TD, Fugate JE, Hocker S, Wijdicks EFM, Aksamit AJ, Rabinstein AA (2016) Predictors of outcome in HSV encephalitis. J Neurol 263:277–289. https://doi.org/10.1007/s00415-015-7960-8CrossRefPubMed

20.

Ryan L, Heed A, Foster J, Valappil M, Schmid ML, Duncan CJA (2018) Acute kidney injury (AKI) associated with intravenous aciclovir in adults: incidence and risk factors in clinical practice. Int J Infect Dis 74:97–99. https://doi.org/10.1016/j.ijid.2018.07.002CrossRefPubMed

21.

Martinot M, Klein A, Demesmay K, Groza M, Mohseni-Zadeh M, Tebacher-Alt M et al (2019) Acute renal failure related to high doses of acyclovir (15 mg/kg/8 h) during treatment of varicella zoster virus encephalitis. Antivir Ther (Lond) 24:309–312. https://doi.org/10.3851/IMP3313CrossRef

22.

Sawyer MH, Webb DE, Balow JE, Straus SE (1988) Acyclovir-induced renal failure. Clinical course and histology. Am J Med 84:1067–1071. https://doi.org/10.1016/0002-9343(88)90313-0CrossRefPubMed

Title: Characteristics and outcome of varicella-zoster virus central nervous system infections in adults
Authors: A. Le Bot
A. Ballerie
C. Pronier
F. Bénézit
F. Reizine
M. Tas
P. Jégo
M. Revest
Y. Le Tulzo
P. Fillâtre
Pierre Tattevin
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: Shingles
Human Alphaherpesvirus 3
Meningoencephalitis
Aciclovir
Meningitis
Encephalitis
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 11/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-021-04245-y

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