Meningoencephalitis
 | This article mayrequirecleanupto meet Wikipedia'squality standards.The specific problem is:Diagnosis section needs cleanup/article in general needs improvement.(January 2019) |
| Meningoencephalitis | |
|---|---|
| Other names | Herpes meningoencephalitis[1][2] |
 | |
| Meninges | |
| Specialty | Infectious disease,neurology |
Meningoencephalitis(/mɪˌnɪŋɡoʊɛnˌsɛfəˈlaɪtɪs,-ˌnɪndʒoʊ-,-ən-,-ˌkɛ-/;[3][4]fromAncient Greek:μῆνιγξ,romanized:meninx,lit. 'membrane';Ancient Greek:ἐγκέφαλος,romanized:enképhalos,lit. 'brain'; and the medical suffix-itis,"inflammation" ), also known asherpes meningoencephalitis,is amedical conditionthat simultaneously resembles bothmeningitis,which is aninfectionorinflammationof themeninges,andencephalitis,which is an infection or inflammation of thebrain tissue.
Signs and symptoms
[edit]Signs of meningoencephalitis includeunusual behavior,personality changes,nausea and thinking problems.[1][5]
Symptoms may includeheadache,fever,pain in neck movement,light sensitivity,andseizure.[2]
Causes
[edit]Causative organisms includeprotozoans,viralandbacterialpathogens.[citation needed]
Specific types include:
Bacterial
[edit]Veterinarians have observed meningoencephalitis inanimals infected with listeriosis,caused by the pathogenic bacteriaL. monocytogenes.Meningitis and encephalitis already present in the brain or spinal cord of an animal may form simultaneously into meningeoencephalitis.[6]The bacterium commonly targets the sensitive structures of the brain stem.L. monocytogenesmeningoencephalitis has been documented to significantly increase the number ofcytokines,such asIL-1β,IL-12,IL-15,leading to toxic effects on the brain.[7]
Meningoencephalitis may be one of the severe complications of diseases originating from severalRickettsiaspecies, such asRickettsia rickettsii(agent ofRocky Mountain spotted fever(RMSF)),Rickettsia conorii,Rickettsia prowazekii(agent ofepidemic louse-borne typhus), andRickettsia africae.It can cause impairments to thecranial nerves,paralysis to the eyes, and suddenhearing loss.[8][9]Meningoencephalitis is a rare, late-stage manifestation of tick-borne ricksettial diseases, such as RMSF andhuman monocytotropic ehrlichiosis(HME), caused byEhrlichia chaffeensis(a species of rickettsiales bacteria).[10]
Other bacteria that can cause it areMycoplasma pneumoniae,Tuberculosis,Borrelia(Lyme disease) andLeptospirosis.
Viral
[edit]- Tick-borne encephalitis
- West Nile virus
- Measles
- Epstein–Barr virus
- Varicella-zoster virus
- Enterovirus
- Herpes simplex virus type 1
- Herpes simplex virus type 2
- Rabies virus
- Adenovirus,although meningoencephalitis is almost solely seen in heavily immunocompromised patients.[11]
- Mumps,a relatively common cause of meningoencephalitis. However, most cases are mild, and mumps meningoencephalitis generally does not result in death or neurologicsequelae.[12]
- HIV,a very small number of individuals exhibit meningoencephalitis at theprimary stageof infection.[13][14]
Autoimmune
[edit]- Antibodiestargetingamyloid betapeptideproteinswhich have been used during research onAlzheimer's disease.[15]
- Anti-N-methyl-D-aspartate (anti-NMDA) receptor antibodies, which are also associated with seizures and a movement disorder, and related toanti-NMDA receptor encephalitis.
- NAIMor "Nonvasculitic autoimmune inflammatory meningoencephalitis" (NAIM).[16]They can be divided into GFAP- and GFAP+ cases. The second is related to theautoimmune GFAP astrocytopathy.
Protozoal
[edit]Animal
[edit]Thisnematodeis an exceptionally rare cause of meningoencephalitis.[17]
Other/multiple
[edit]Other causes includegranulomatous meningoencephalitisandvasculitis.The fungus,Cryptococcus neoformans,can be symptomatically manifested within theCNSas meningoencephalitis withhydrocephalusbeing a very characteristic finding due to the unique thickpolysaccharidecapsule of the organism.[citation needed]
Diagnosis
[edit]Clinical diagnosis includes evaluation for the presence of recurrent or recent herpes infection, fever, headache, altered mental status, convulsions, disturbance of consciousness, and focal signs. Testing of cerebrospinal fluid is usually performed.[citation needed]
Treatment
[edit] | This sectionneeds additional citations forverification.(April 2019) |
Antiviral therapy, such asacyclovirandganciclovir,work best when applied as early as possible. May also be treated withinterferonas an immune therapy. Symptomatic therapy can be applied as needed. High fever can be treated by physical regulation of body temperature. Seizure can be treated withantiepileptic drugs.High intracranial pressure can be treated with drugs such asmannitol.If caused by an infection then the infection can be treated withantibioticdrugs.[citation needed]
See also
[edit]References
[edit]- ^ab"Herpes Meningoencephalitis".Johns Hopkins Medicine.The Johns Hopkins University, The Johns Hopkins Hospital, and The Johns Hopkins Health System Corporation.Retrieved26 January2019.
- ^ab"Herpes Meningoencephalitis".Columbia University Department of Neurology.Columbia University.Retrieved26 January2019.
- ^"Meningoencephalitis".LexicoUK English Dictionary.Oxford University Press.Archived fromthe originalon 2020-03-22.
- ^"Meningoencephalitis".Merriam-Webster.com Dictionary.Retrieved2016-01-21.
- ^Shelat, Amit; Ziegler, Olivia."Herpes Meningoencephalitis".University of Rochester Medical Center - Health Encyclopedia.University of Rochester Medical Center Rochester, NY.Retrieved26 January2019.
- ^Long, Maureen."Overview of Meningitis, Encephalitis, and Encephalomyelitis".Merck Manual: Veterinary Manual.Merck Sharp & Dohme Corp.Retrieved28 January2019.
- ^Deckert, Martina; Soltek, Sabine; Geginat, Gernot; Lütjen, Sonja; Montesinos-Rongen, Manuel; Hof, Herbert; Schlüter, Durk (July 2001)."Endogenous Interleukin-10 Is Required for Prevention of a Hyperinflammatory Intracerebral Immune Response in Listeria monocytogenes Meningoencephalitis".Infect. Immun.69(7): 4561–4571.doi:10.1128/IAI.69.7.4561-4571.2001.PMC98533.PMID11402000.
- ^Biggs, Holly (2016)."Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States".MMWR. Recommendations and Reports.65(2). U.S. Department of Health & Human Services: 1–44.doi:10.15585/mmwr.rr6502a1.PMID27172113.
- ^Ryan, Edward; Durand, Marlene (2011). "CHAPTER 135 - Ocular Disease".Tropical Infectious Diseases: Principles, Pathogens and Practice (Third Edition).III:991–1016.doi:10.1016/B978-0-7020-3935-5.00135-X.ISBN9780702039355.
- ^Huntzinger, Amber (July 2007)."Guidelines for the Diagnosis and Treatment of Tick-Borne Rickettsial Diseases".American Family Physician.76(1). American Academy of Family Physicians: 137.Retrieved30 January2019.
- ^Carrigan, Phd (1997)."Adenovirus Infections in Immunocompromised Patients".The American Journal of Medicine.102(3): 71–74.doi:10.1016/S0002-9343(97)00015-6.PMID10868146.
- ^Bruyn HB, Sexton HM, Brainerd HD (March 1957)."Mumps meningoencephalitis; a clinical review of 119 cases with one death".Calif Med.86(3): 153–60.PMC1512024.PMID13404512.
- ^Newton, PJ; Newsholme, W; Brink, NS; Manji, H; Williams, IG; Miller, RF (2002)."Acute meningoencephalitis and meningitis due to primary HIV infection".BMJ (Clinical Research Ed.).325(7374): 1225–7.doi:10.1136/bmj.325.7374.1225.PMC1124692.PMID12446542.
- ^Del Saz, SV; Sued, O; Falcó, V; Agüero, F; Crespo, M; Pumarola, T; Curran, A; Gatell, JM; et al. (2008). "Acute meningoencephalitis due to human immunodeficiency virus type 1 infection in 13 patients: clinical description and follow-up".Journal of NeuroVirology.14(6): 474–9.doi:10.1080/13550280802195367.PMID19037815.S2CID9473244.
- ^Orgogozo JM, Gilman S, Dartigues JF, et al. (2003-07-08)."Subacute meningoencephalitis in a subset of patients with AD after Aß42 immunization".Neurology.61(1): 46–54.doi:10.1212/01.WNL.0000073623.84147.A8.PMID12847155.S2CID22582966.
- ^Keith A Josephs, Frank A Rubino, Dennis W Dickson, Nonvasculitic autoimmune inflammatory meningoencephalitis, Neuropathology 24(2):149-52 · July 2004, DOI: 10.1111/j.1440-1789.2004.00542.x
- ^"Rare parasitic worm kills two kidney donor patients, inquest hears".The Guardian.2014-11-18.Retrieved2014-11-24.
External links
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