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Case Rep Psychiatry 2021 23;2021:6687735. Epub 2021 Apr 23.

Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.

Viral encephalitis often presents with severe illness, headache, fever, behavioral changes, altered level of consciousness, and focal neurologic deficits. One of the most feared kind of virus encephalitis is herpes simplex encephalitis; however, other central virus infections are also capable of presenting with psychiatric symptoms. Here, we report the case of a 22-year-old woman with first time visual and auditory hallucinations due to an acute enterovirus encephalitis with no cerebrospinal fluid abnormalities but a positive PCR result for enterovirus (ECHO). Read More

Antiviral Res 2021 May 6:105087. Epub 2021 May 6.

National Center for Biodefense and Infectious Diseases, George Mason University, Manassas, VA, 20110 USA; Department of Biomedical Sciences and Pathobiology, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA; Center for Zoonotic and Arthropod-borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA. Electronic address:

Marine microorganisms have been a resource for novel therapeutic drugs for decades. In addition to anticancer drugs, the drug acyclovir, derived from a marine sponge, is FDA-approved for the treatment of human herpes simplex virus-1 infections. Most alphaviruses that are infectious to terrestrial animals and humans, such as Venezuelan and eastern equine encephalitis viruses (VEEV and EEEV), lack efficient antiviral drugs and it is imperative to develop these remedies. Read More

Pediatr Neurol 2021 Apr 7;120:27-32. Epub 2021 Apr 7.

Department of Pediatrics, Peking University People's Hospital, Beijing, P.R. China. Electronic address:

Autoimmune encephalitis (AE) is an increasingly recognized inflammatory disorder of the central nervous system and is most often characterized by antibodies against intracellular and neuronal surface antigens. AE is a devastating disease that may result in developmental delay or regression in children. However, the pathogenesis of AE is not clear, and immune system disorders after infection likely play an important role in AE. Read More

Trans R Soc Trop Med Hyg 2021 Apr 23. Epub 2021 Apr 23.

ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India.

Background: Acute encephalitis syndrome (AES) is a major public health concern in India, causing febrile illness principally associated with viral infection. Bacteria-like scrub typhus and leptospirosis also cause acute febrile illness. Therefore, this study was conceived to address the possible etiological agents contributing to sporadic AES in a tertiary care center in Odisha, India. Read More

Sudan J Paediatr 2021 ;21(1):76-81

Division of Pediatric Neurology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is an immune-mediated syndrome that is still under-recognised, with grave consequences if not treated early. A multidisciplinary team approach is required in the process of diagnosis and management of this potentially treatable and reversible disorder. We report on a 26-month-old Sudanese girl who presented with focal seizures associated with fever (temperature = 38. Read More

Neurohospitalist 2021 Jan 22;11(1):66-70. Epub 2020 Jul 22.

Division of Neurology, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada.

Untreated herpes simplex virus type 1 (HSV-1) encephalitis is associated with high mortality. Missed cases can have devastating consequences. Detection of HSV-1 in cerebrospinal fluid (CSF) with polymerase chain reaction (PCR) is reported to have high sensitivity and specificity and is considered the diagnostic gold standard for HSV-1 encephalitis. Read More

J Neurovirol 2021 Apr 8. Epub 2021 Apr 8.

Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico (NINN), Insurgentes sur 3877, 14269, Mexico City, Mexico.

The frequency of central nervous system infections due to herpesvirus have been studied in various populations; however, studies in Mexican mestizo patients are scant. This paper documents the frequency of herpesvirus encephalitis in Mexican mestizo patients from the National Institute of Neurology and Neurosurgery (NINN) of Mexico. To study the frequency of herpetic viral encephalitis at the NINN in the period from 2004 to 2009. Read More

J Pak Med Assoc 2021 Feb;71(2(A)):569-570

5th Year MBBS Student, Army Medical College, Rawalpindi, Pakistan.

J Child Neurol 2021 Apr 5:8830738211002679. Epub 2021 Apr 5.

Division of Pediatric Neurology, Department of Pediatrics, Children's Hospital of Alabama, 9968University of Alabama at Birmingham, Birmingham, AL, USA.

Objective: To compare clinical, diagnostic, management, and outcome factors in children with anti--methyl-d-aspartate receptor (NMDAR) encephalitis and a history of herpes simplex encephalitis (HSE) to children with NMDAR encephalitis without a history of HSE.

Methods: All patients with anti-NMDAR antibodies in cerebrospinal fluid treated at our institution between 2012 and 2019 were identified and divided into those with a history of HSE (HSE+NMDAR group) and those without a history of HSE (NMDAR-only group). Demographic data, clinical characteristics, immunotherapy, and outcome data were collected on all patients and compared between the 2 groups. Read More

Clin Microbiol Infect 2021 Apr 1. Epub 2021 Apr 1.

Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address:

Background: Serological techniques are an essential part of the diagnostic tools used in clinical virology. Among these techniques, antibody indexes are not novel, but do require specific expertise. Their niche has expanded substantially in recent years due to increasing evidence of their performance to diagnose viral infections. Read More

Arch Immunol Ther Exp (Warsz) 2021 Apr 3;69(1):10. Epub 2021 Apr 3.

N.F. Gamaleya National Research Center of Epidemiology and Microbiology of the Ministry of Health of Russia, Gamaleya 18, Moscow, Russia, 123098.

The review discusses a new approach to the prevention and treatment of viral infections based on the use of pine needles polyprenyl phosphate (PPP) and associated with the infringement of prenylation process-the attachment of farnesol or geranyl geraniol to the viral protein. Currently, prenylation has been detected in type 1 adenovirus, hepatitis C virus, several herpes viruses, influenza virus, HIV. However, this list is far from complete, given that prenylated proteins play an extremely important role in the activity of the virus. Read More

J Neurovirol 2021 Mar 31. Epub 2021 Mar 31.

Department of Medical Microbiology, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkey.

Herpes simplex virus encephalitis (HSE) is the most common sporadic fatal encephalitis. Although timely administered acyclovir treatment decreases mortality, neuropsychiatric sequelae is still common among survivors. Magnetic resonance imaging is frequently utilized for the diagnosis of HSE, which typically involves temporal lobe(s) and can be mixed with brain tumors involving the same area. Read More

Cureus 2021 Feb 22;13(2):e13494. Epub 2021 Feb 22.

Internal Medicine/Nephrology, Virginia Commonwealth University, Richmond, USA.

There are a few cases of valacyclovir-associated neurotoxicity (VAN) reported. This case report documents a case of a 55-year-old male presenting with emotional lability or pseudobulbar affect as the predominant or sole manifestation of VAN. A failure to adjust valacyclovir's dose for herpes simplex infection in the setting of dialysis-dependent end-stage renal disease (ESRD) preceded VAN in this patient. Read More

Ocul Surf 2021 Mar 22. Epub 2021 Mar 22.

Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, 60612, USA; Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, 60612, USA. Electronic address:

Purpose: Herpes simplex virus-1 (HSV-1) infection leads to varying pathologies including the development of ocular lesions, stromal keratitis and encephalitis. While the role for host immunity in disease progression is well understood, the contribution of genetic variances in generating preferential viral entry receptor usage and resulting immunopathogenesis in humans are not known.

Methods: Ocular cultures were obtained from patients presenting distinct pathologies of herpes simplex keratitis (HSK). Read More

mBio 2021 03 16;12(2). Epub 2021 Mar 16.

Laboratory of Structural Biology Research, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA

Herpes simplex virus 1 (HSV-1) requires seven proteins to package its genome through a vertex in its capsid, one of which is the portal protein, pUL6. The portal protein is also thought to facilitate assembly of the procapsid. While the portal has been visualized in mature capsids, we aimed to elucidate its role in the assembly and maturation of procapsids using cryo-electron tomography (cryoET). Read More

Front Immunol 2021 15;12:635257. Epub 2021 Feb 15.

Millennium Institute on Immunology and Immunotherapy, Santiago, Chile.

Multiple sclerosis (MS) is an increasingly prevalent progressive autoimmune and debilitating chronic disease that involves the detrimental recognition of central nervous system (CNS) antigens by the immune system. Although significant progress has been made in the last decades on the biology of MS and the identification of novel therapies to treat its symptoms, the etiology of this disease remains unknown. However, recent studies have suggested that viral infections may contribute to disease onset. Read More

Vaccines (Basel) 2021 Feb 16;9(2). Epub 2021 Feb 16.

Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Via Fossato di Mortara 64/b, 44121 Ferrara, Italy.

Herpes simplex virus type 1 and 2 (HSV1 and HSV2) are global, widespread human pathogens transmitted by direct contact that cause lifelong, recurrent asymptomatic and painful symptomatic clinical illnesses (cold sores, keratitis, blepharitis, meningitis, encephalitis, genital infections), overt disease and severe sequelae in neonatal and immune-compromised patients, and increased risk of cervical cancer and other sexually transmitted infections, including HIV [... Read More

Bio Protoc 2020 Sep 5;10(17):e3748. Epub 2020 Sep 5.

Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, USA.

The efficiency of cleavage of individual CRISPR/Cas9-sgRNAs remains difficult to predict based on the CRISPR target sequence alone. Different intracellular environments (dependent on cell type or cell cycle state for example) may affect sgRNA efficiency by altering accessibility of genomic DNA through DNA modifications such as epigenetic marks and DNA-binding proteins (, histones) as well as alteration of the chromatin state of genomic DNA within the nucleus. We recently reported a multi-step screening method for the identification of efficient sgRNAs targeting the Herpes simplex virus (HSV-1) genome and reported a differential mechanism for viral inhibition by CRISPR-Cas9 in the latent versus lytic phase. Read More

Acta Pharm Sin B 2021 Feb 25;11(2):373-393. Epub 2020 Aug 25.

Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital & Department of Radiology, Harvard Medical School, Boston, MA 02114, USA.

The 18 kDa translocator protein (TSPO), previously known as the peripheral benzodiazepine receptor, is predominately localized to the outer mitochondrial membrane in steroidogenic cells. Brain TSPO expression is relatively low under physiological conditions, but is upregulated in response to glial cell activation. As the primary index of neuroinflammation, TSPO is implicated in the pathogenesis and progression of numerous neuropsychiatric disorders and neurodegenerative diseases, including Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), multiple sclerosis (MS), major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Read More

Intervirology 2021 24;64(2):88-95. Epub 2021 Feb 24.

Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,

Introduction: Herpes simplex viruses (HSVs) are widely distributed in the human population. HSV type 1 (HSV-1) is responsible for a spectrum of diseases, ranging from gingivostomatitis to keratoconjunctivitis, and encephalitis. The HSVs establish latent infections in nerve cells, and recurrences are common. Read More

Neuropediatrics 2021 Feb 12. Epub 2021 Feb 12.

Department of Pediatric Neurology, Hacettepe University Medical Faculty, Ankara, Turkey.

Encephalitis is a serious neurological syndrome caused by inflammation of the brain. The diagnosis can be challenging and etiology remains unidentified in about half of the pediatric cases. We aimed to investigate demographic, clinical, laboratory, electroencephalographic and neuroimaging findings, and outcome of acute encephalitis of nonbacterial etiology. Read More

Ocul Immunol Inflamm 2021 Feb 4:1-7. Epub 2021 Feb 4.

Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan.

Purpose: To report a case of a neonate with acute retinal necrosis, lens vacuoles, and encephalitis associated with herpes simplex virus (HSV) infection.

Design: Case report.

Methods: Retrospective chart review. Read More

Vopr Virusol 2021 Jan 7;65(6):373-380. Epub 2021 Jan 7.

FSBIS I.Ya. Postovsky Institute of Organic Synthesis of the Ural Branch of the Russian Academy of Sciences; FSAEI HE «Ural Federal University named after the First President of Russia B.N. Yeltsin».

Introduction: Herpes simplex viruses type 1 (HSV-1) are extremely widespread throughout the world and, similar to other herpesviruses, establish lifelong persistent infection in the host. Reactivating sporadically, HSV-1 elicits recurrences in both immunocompetent and immunocompromised individuals and can cause serious diseases (blindness, encephalitis, generalized infections). The currently available antiherpetic drugs that aimed mainly at suppressing replication of viral DNA are not always effective enough, for example, due to the development of drug resistance. Read More

BMC Neurol 2021 Feb 2;21(1):49. Epub 2021 Feb 2.

Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.

Background: Virus encephalitis is found to be a risk factor for acute retinal necrosis (ARN).

Case Presentation: We herein presented a case of a 20-year-old teenage boy who suffered from encephalitis of unknown etiology with early negative pathologic results, and was primarily treated with systemic administration of high-dose steroids without antiviral therapy. He later had sudden vision loss in his right eye. Read More

Pediatr Rev 2021 Feb;42(2):68-77

Division of Pediatric Infectious Diseases, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR.

Encephalitis is defined as altered mental status for more than 24 hours accompanied by 2 or more findings concerning for inflammation of the brain parenchyma: fever, seizures or other focal neurologic disorders, cerebrospinal fluid pleocytosis, and abnormal neuroimaging and electroencephalographic findings. Herpes simplex virus causes the most severe form of virus-induced encephalitis; the early administration of acyclovir can improve the prognosis of this disease. The rising interest in autoimmune causes of encephalitis, most notably anti--methyl-d-aspartate receptor, should prompt the clinician to consider immunomodulatory treatments, which may improve outcomes. Read More

Neurosurg Focus 2021 02;50(2):E2

1Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Objective: High-grade gliomas (HGGs) inevitably recur and progress despite resection and standard chemotherapies and radiation. Viral therapies have emerged as a theoretically favorable adjuvant modality that might overcome intrinsic factors of HGGs that confer treatment resistance.

Methods: The authors present the results of systematic searches of the MEDLINE and ClinicalTrials. Read More

PLoS Pathog 2021 Feb 1;17(2):e1009285. Epub 2021 Feb 1.

Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.

Herpes simplex virus encephalitis (HSE) is the most common cause of sporadic viral encephalitis, and despite targeted antiviral therapy, outcomes remain poor. Although the innate immune system is critical for restricting herpes simplex virus type I (HSV-1) in the brain, there is evidence that prolonged neuroinflammation contributes to HSE pathogenesis. In this study, we investigated the contribution of inflammasomes to disease pathogenesis in a murine model of HSE. Read More

Neurology 2021 04 25;96(14):679-681. Epub 2021 Jan 25.

From the Department of Neurology, Massachusetts General Hospital, Boston.

Clin Neurol Neurosurg 2021 Mar 19;202:106507. Epub 2021 Jan 19.

Department of Neurology, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Republic of Korea.

Introduction: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) samples has greatly facilitated the diagnosis of central nervous system (CNS) infections. However, the clinical significance of Epstein-Barr virus (EBV) DNA in CSF of individuals with suspected CNS infection remains unclear. We wanted to gain a better understanding of EBV as an infectious agent in immunocompetent patients with CNS disorders. Read More

Pneumonia (Nathan) 2021 Jan 25;13(1). Epub 2021 Jan 25.

Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland.

Background: Herpes simplex virus (HSV) is commonly associated with oro-facial and genital manifestations. It rarely causes encephalitis and even less commonly, in heavily immunosuppressed patients, visceral disease or bronchopneumonitis. We present a case of cytologically-proven, PCR-positive HSV-1 tracheobronchitis and pneumonitis in a patient with less severe immunocompromise. Read More