1887

Chapter 3 : Viral Central Nervous System Infections

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

Viral Central Nervous System Infections, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815981/9781555814250_Chap03-1.gif /docserver/preview/fulltext/10.1128/9781555815981/9781555814250_Chap03-2.gif

Abstract:

Viral disease in the central nervous system (CNS) can be classified by pathogenesis. Neurologic disease is frequently categorized as either primary or postinfectious. Primary encephalitis results from direct viral entry into the CNS that produces clinically evident cortical or brain stem dysfunction. Meningitis and encephalitis represent separate clinical entities; however, a continuum exists between these distinct forms of disease. A change in a patient’s clinical condition can reflect disease progression with involvement of different regions of the brain. Epidemiological data in many cases provide clues to the etiology of the illness. Viral meningitis is a relatively benign self-limited illness, and pathological specimens are rarely available for study. The diagnosis of viral meningitis relied on viral culture, and CSF viral culture rates differ based on etiology. The fundamental principle of therapy for viral meningitis lies in the identification of potentially treatable diseases. Similar to the case with viral meningitis, passive reporting systems underestimate the incidence of viral encephalitis. The pathogenesis of encephalitis requires that viruses reach the CNS by hematogenous or neuronal spread. Patients with encephalitis, depending on the etiology and extent of CNS involvement, require treatment tailored to their clinical situation. The approach to a patient with a presumed CNS viral infection must be tailored to the severity and distribution of neurologic involvement. Improvements in ability to diagnose CNS infections will produce a better understanding of the pathogenesis and true extent of CNS viral disease.

Citation: Cassady K, Whitley R. 2009. Viral Central Nervous System Infections, p 29-44. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch3

Key Concept Ranking

Viral Central Nervous System Diseases
0.5418604
0.5418604
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of FIGURE 1
FIGURE 1

Body surfaces as sites of virus infection and shedding.

Citation: Cassady K, Whitley R. 2009. Viral Central Nervous System Infections, p 29-44. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch3
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2
FIGURE 2

Routes of viral invasion of the CNS.

Citation: Cassady K, Whitley R. 2009. Viral Central Nervous System Infections, p 29-44. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch3
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555815981.ch03
1. Abzug, M. J.,, G. Cloud,, J. Bradley,, P. J. Sanchez,, J. Romero,, D. Powell,, M. Lepow,, C. Mani,, E. V. Capparelli,, S. Blount,, F. Lakeman,, R. J. Whitley, and, D. W. Kimberlin. 2003. Double blind placebo-controlled trial of pleconaril in infants with enterovirus meningitis. Pediatr. Infect. Dis. J. 22:335341.
2. Abzug, M. J.,, H. L. Keyserling,, M. L. Lee,, M. J. Levin, and, H. A. Rotbart. 1995. Neonatal enterovirus infection: virology, serology, and effects of intravenous immune globulin. Clin. Infect. Dis. 20:12011206.
3. Ayukawa, R.,, H. Fujimoto,, M. Ayabe,, H. Shoji,, R. Matsui,, Y. Iwata,, H. Fukuda,, K. Ochi,, K. Noda,, Y. Ono,, K. Sakai,, Y. Takehisa, and, K. Yasui. 2004. An unexpected outbreak of Japanese encephalitis in the Chugoku District of Japan, 2002. Jpn. J. Infect. Dis. 57:6366.
4. Bauer, S.,, G. Gottesman,, L. Sirota,, I. Litmanovitz,, S. Ashkenazi, and, I. Levi. 2002. Severe coxsackie virus b infection in preterm newborns treated with pleconaril. Eur. J. Pediatr. 161:491493.
5. Becher, B.,, A. Prat, and, J. P. Antel. 2000. Brain-immune connection: immuno-regulatory properties of CNS-resident cells. Glia 29:293304.
6. Bergstrom, T.,, A. Vahlne,, K. Alestig,, S. Jeansson,, M. Forsgren, and, E. Lycke. 1990. Primary and recurrent herpes simplex virus type 2-induced meningitis. J. Infect. Dis. 162:322330.
7. Cassady, K. A.,, and R. J. Whitley. 2002. Viral central nervous system infections, p. 27–44. In D. D. Richman,, R. J. Whitley, and, F. G. Hayden (ed.), Clinical Virology, 2nd ed. ASM Press, Washington, DC.
8. Centers for Disease Control and Prevention. 2004. Bovine spongiform encephalopathy in a dairy cow—Washington State, 2003. Morb. Mortal. Wkly. Rep. 52:12801285.
9. Centers for Disease Control and Prevention. 2000. Human rabies—California, Georgia, Minnesota, New York, and Wisconsin, 2000. Morb. Mortal. Wkly. Rep. 49:11111115.
10. Chou, J.,, E. R. Kern,, R. J. Whitley, and, B. Roizman. 1990. Mapping of herpes simplex virus-1 neurovirulence to gamma 134.5, a gene nonessential for growth in culture. Science 250:12621266.
11. Collee, J. G.,, R. Bradley, and, P. P. Liberski. 2006. Variant CJD (vCJD) and bovine spongiform encephalopathy (BSE): 10 and 20 years on: part 2. Folia Neuropathol. 44:102110.
12. Conway, J. H.,, A. Weinberg,, R. L. Ashley,, J. Amer, and, M. J. Levin. 1997. Viral meningitis in a preadolescent child caused by reactivation of latent herpes simplex (type 1). Pediatr. Infect. Dis. J. 16:627629.
13. Cunningham, C. K.,, C. A. Bonville,, H. D. Ochs,, K. Seyama,, P. A. John,, H. A. Rotbart, and, L. B. Weiner. 1999. Enteroviral meningoencephalitis as a complication of X-linked hyper IgM syndrome. J. Pediatr. 134:584588.
14. Debiasi, R. L.,, and K. L. Tyler. 2004. Molecular methods for diagnosis of viral encephalitis. Clin. Microbiol. Rev. 17:903925, table of contents.
15. De La Blanchardiere, A.,, F. Rozenberg,, E. Caumes,, O. Picard,, F. Lionnet,, J. Livartowski,, J. Coste,, D. Sicard,, P. Lebon, and, D. Salmon-Ceron. 2000. Neurological complications of varicella-zoster virus infection in adults with human immunodeficiency virus infection. Scand. J. Infect. Dis. 32:263269.
16. Deresiewicz, R. L.,, S. J. Thaler,, L. Hsu, and, A. A. Zamani. 1997. Clinical and neuroradiographic manifestations of eastern equine encephalitis. N. Engl. J. Med. 336:18671874.
17. Desmond, R. A.,, N. A. Accortt,, L. Talley,, S. A. Villano,, S. J. Soong, and, R. J. Whitley. 2006. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob. Agents Chemother. 50:24092414.
18. Dobra, S. A.,, and P. G. Bennett. 2006. vCJD and blood transfusion: risk assessment in the United Kingdom. Transfus. Clin. Biol. 13:307311.
19. Domingues, R. B.,, F. D. Lakeman,, M. S. Mayo, and, R. J. Whitley. 1998. Application of competitive PCR to cerebrospinal fluid samples from patients with herpes simplex encephalitis. J. Clin. Microbiol. 36:22292234.
20. Echevarria, J. M.,, I. Casas, and, P. Martinez-Martin. 1997. Infections of the nervous system caused by varicella-zoster virus: a review. Intervirology 40:7284.
21. Edens, H. A.,, and C. A. Parkos. 2000. Modulation of epithelial and endothelial paracellular permeability by leukocytes. Adv. Drug Delivery Rev. 41:315328.
22. Fonseca-Aten, M.,, A. F. Messina,, H. S. Jafri, and, P. J. Sanchez. 2005. Herpes simplex virus encephalitis during suppressive therapy with acyclovir in a premature infant. Pediatrics 115:804809.
23. Fragoso-Loyo, H.,, Y. Richaud-Patin,, A. Orozco-Narvaez,, L. Davila-Maldonado,, Y. Atisha-Fregoso,, L. Llorente, and, J. Sanchez-Guerrero. 2007. Interleukin-6 and chemokines in the neuropsychiatric manifestations of systemic lupus erythematosus. Arthritis Rheum. 56:12421250.
24. Gilden, D. H.,, B. K. Kleinschmidt-DeMasters,, J. J. LaGuardia,, R. Mahalingam, and, R. J. Cohrs. 2001. Neurologic complications of the reactivation of varicellazoster virus. N. Engl. J. Med. 342:635645.
25. Griffin, D. E. 1998. A review of alphavirus replication in neurons. Neurosci. Biobehav. Rev. 22:721723.
26. Handy, R.,, and S. Lang. 2004. Flavivirus encephalitis. N. Engl. J. Med. 351:18031804. (Author’s reply, 351: 1803–1804.)
27. Hewitt, P. 2006. vCJD and blood transfusion in the United Kingdom. Transfus. Clin. Biol. 13:312316.
28. Hilton, D. A. 2006. Pathogenesis and prevalence of variant Creutzfeldt-Jakob disease. J. Pathol. 208:134141.
29. Ho, D. D.,, and M. S. Hirsch. 1985. Acute viral encephalitis. Med. Clin. N. Am. 69:415429.
30. Hosoya, M.,, K. Honzumi,, M. Sato,, M. Katayose,, K. Kato, and, H. Suzuki. 1998. Application of PCR for various neurotropic viruses on the diagnosis of viral meningitis. J. Clin. Virol. 11:117124.
31. Ichiyama, T.,, S. Maeba,, N. Suenaga,, K. Saito,, T. Matsubara, and, S. Furukawa. 2005. Analysis of cytokine levels in cerebrospinal fluid in mumps meningitis: comparison with echovirus type 30 meningitis. Cytokine 30:243247.
32. Jeffery, K. J.,, S. J. Read,, T. E. Peto,, R. T. Mayon-White, and, C. R. Bangham. 1997. Diagnosis of viral infections of the central nervous system: clinical interpretation of PCR results. Lancet 349:313317.
33. Jensenius, M.,, B. Myrvang,, G. Storvold,, A. Bucher,, K. B. Hellum, and, A. L. Bruu. 1998. Herpes simplex virus type 2 DNA detected in cerebrospinal fluid of 9 patients with Mollaret’s meningitis. Acta Neurol. Scand. 98:209212.
34. Kennedy, P. G. 2005. Viral encephalitis. J. Neurol. 252:268272.
35. Khetsuriani, N.,, R. C. Holman,, A. C. Lamonte-Fowlkes,, R. M. Selik, and, L. J. Anderson. 2007. Trends in encephalitis-associated deaths in the United States. Epidemiol. Infect. 135:583591.
36. Kiderlen, A. F.,, and U. Laube. 2004. Balamuthia mandrillaris, an opportunistic agent of granulomatous amebic encephalitis, infects the brain via the olfactory nerve pathway. Parasitol. Res. 94:4952.
37. Kimura, H.,, M. Futamura,, H. Kito,, T. Ando,, M. Goto,, K. Kuzushima,, M. Shibata, and, T. Morishima. 1991. Detection of viral DNA in neonatal herpes simplex virus infections: frequent and prolonged presence in serum and cerebrospinal fluid. J. Infect. Dis. 164:289293.
38. Koskiniemi, M.,, M. Korppi,, K. Mustonen,, H. Rantala,, M. Muttilainen,, E. Herrgard,, P. Ukkonen, and, A. Vaheri. 1997. Epidemiology of encephalitis in children. A prospective multicentre study. Eur. J. Pediatr. 156:541545.
39. Krasnianski, A.,, B. Meissner,, U. Heinemann, and, I. Zerr. 2004. Clinical findings and diagnostic tests in Creutzfeldt-Jakob disease and variant Creutzfeldt-Jakob disease. Folia Neuropathol. 42(Suppl. B):2438.
40. Kuno, G. 1998. Universal diagnostic RT-PCR protocol for arboviruses. J. Virol. Methods 72:2741.
41. Kupila, L.,, T. Vuorinen,, R. Vainionpaa,, V. Hukkanen,, R. J. Marttila, and, P. Kotilainen. 2006. Etiology of aseptic meningitis and encephalitis in an adult population. Neurology 66:7580.
42. Kupila, L.,, T. Vuorinen,, R. Vainionpaa,, R. J. Marttila, and, P. Kotilainen. 2005. Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clin. Infect. Dis. 40:982987.
43. Lee, B. E.,, and H. D. Davies. 2007. Aseptic meningitis. Curr. Opin. Infect. Dis. 20:272277.
44. Markovitz, N. S.,, D. Baunoch, and, B. Roizman. 1997. The range and distribution of murine central nervous system cells infected with the γ134.5 mutant of herpes simplex virus 1. J. Virol. 71:55605569.
45. Maschke, M.,, O. Kastrup,, S. Esser,, B. Ross,, U. Hengge, and, A. Hufnagel. 2000. Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART). J. Neurol. Neurosurg. Psychiatry 69:376380.
46. Maschke, M.,, O. Kastrup,, M. Forsting, and, H. C. Diener. 2004. Update on neuroimaging in infectious central nervous system disease. Curr. Opin. Neurol. 17:475480.
47. McNabb, S. J.,, R. A. Jajosky,, P. A. Hall-Baker,, D. A. Adams,, P. Sharp,, W. J. Anderson,, A. J. Javier,, G. J. Jones,, D. A. Nitschke,, C. A. Worshams, and, R. A. Richard, Jr. 2007. Summary of notifiable diseases—United States, 2005. Morb. Mortal. Wkly. Rep. 54:192.
48. Meece, J. K.,, J. S. Henkel,, L. Glaser, and, K. D. Reed. 2003. Mosquito surveillance for West Nile virus in southeastern Wisconsin—2002. Clin. Med. Res. 1:3742.
49. Moorthi, S.,, W. N. Schneider, and, M. L. Dombovy. 1999. Rehabilitation outcomes in encephalitis—a retrospective study 1990–1997. Brain Inj. 13:139146.
50. Moran, G. J.,, D. A. Talan,, W. Mower,, M. Newdow,, S. Ong,, J. Y. Nakase,, R. W. Pinner, and, J. E. Childs for the Emergency ID Net Study Group. 2000. Appropriateness of rabies postexposure prophylaxis treatment for animal exposures. JAMA 284:10011007.
51. Nagafuchi, M.,, Y. Nagafuchi,, R. Sato,, T. Imaizumi,, M. Ayabe,, H. Shoji, and, T. Ichiyama. 2006. Adult meningism and viral meningitis, 1997–2004: clinical data and cerebrospinal fluid cytokines. Intern. Med. 45:12091212.
52. Nagai, T.,, T. Okafuji,, C. Miyazaki,, Y. Ito,, M. Kamada,, T. Kumagai,, K. Yuri,, H. Sakiyama,, A. Miyata,, T. Ihara,, H. Ochiai,, K. Shimomura,, E. Suzuki,, S. Torigoe,, M. Igarashi,, T. Kase,, Y. Okuno, and, T. Nakayama. 2007. A comparative study of the incidence of aseptic meningitis in symptomatic natural mumps patients and monovalent mumps vaccine recipients in Japan. Vaccine 25:27422747.
53. Nagy, Z.,, and K. Martinez. 1991. Astrocytic induction of endothelial tight junctions. Ann. N. Y. Acad. Sci. 633:395404.
54. Negrini, B.,, K. J. Kelleher, and, E. R. Wald. 2000. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics 105:316319.
55. Nicolosi, A.,, W. A. Hauser,, E. Beghi, and, L. T. Kurland. 1986. Epidemiology of central nervous system infections in Olmsted County, Minnesota, 1950–1981. J. Infect. Dis. 154:399408.
56. Nigrovic, L. E.,, and V. W. Chiang. 2000. Cost analysis of enteroviral polymerase chain reaction in infants with fever and cerebrospinal fluid pleocytosis. Arch. Pediatr. Adolesc. Med. 154:817821.
57. Nigrovic, L. E.,, N. Kuppermann,, C. G. Macias,, C. R. Cannavino,, D. M. Moro-Sutherland,, R. D. Schremmer,, S. H. Schwab,, D. Agrawal,, K. M. Mansour,, J. E. Bennett,, Y. L. Katsogridakis,, M. M. Mohseni,, B. Bulloch,, D. W. Steele,, R. L. Kaplan,, M. I. Herman,, S. Bandyopadhyay,, P. Dayan,, U. T. Truong,, V. J. Wang,, B. K. Bonsu,, J. L. Chapman,, J. T. Kanegaye, and, R. Malley. 2007. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA 297:5260.
58. Nowak-Wegrzyn, A.,, W. Phipatanakul,, J. A. Winkelstein,, M. S. Forman, and, H. M. Lederman. 2001. Successful treatment of enterovirus infection with the use of pleconaril in 2 infants with severe combined immunodeficiency. Clin. Infect. Dis. 32:E13E14.
59. Palmisano, C. T.,, V. Taylor,, K. Caillouet,, B. Byrd, and, D. M. Wesson. 2005. Impact of West Nile virus outbreak upon St. Tammany Parish Mosquito Abatement District. J. Am. Mosq. Control Assoc. 21:3338.
60. Pape, W. J.,, T. D. Fitzsimmons, and, R. E. Hoffman. 1999. Risk for rabies transmission from encounters with bats, Colorado, 1977–1996. Emerg. Infect. Dis. 5:433437.
61. Parida, M.,, P. K. Dash,, N. K. Tripathi,, S. Ambuj,, S. Sannarangaiah,, P. Saxena,, S. Agarwal,, A. K. Sahni,, S. P. Singh,, A. K. Rathi,, R. Bhargava,, A. Abhyankar,, S. K. Verma,, P. V. Rao, and, K. Sekhar. 2006. Japanese encephalitis outbreak, India, 2005. Emerg. Infect. Dis. 12:14271430.
62. Ramers, C.,, G. Billman,, M. Hartin,, S. Ho, and, M. H. Sawyer. 2000. Impact of a diagnostic cerebrospinal fluid enterovirus polymerase chain reaction test on patient management. JAMA 283:26802685.
63. Rodriguez, S. C.,, A. M. Olguin,, C. P. Miralles, and, P. F. Viladrich. 2006. Characteristics of meningitis caused by ibuprofen: report of 2 cases with recurrent episodes and review of the literature. Medicine (Baltimore) 85:214220.
64. Rorabaugh, M. L.,, L. E. Berlin,, F. Heldrich,, K. Roberts,, L. A. Rosenberg,, T. Doran, and, J. F. Modlin. 1993. Aseptic meningitis in infants younger than 2 years of age: acute illness and neurologic complications. Pediatrics 92:206211.
65. Rotbart, H. A.,, P. J. Brennan,, K. H. Fife,, J. R. Romero,, J. A. Griffin,, M. A. McKinlay, and, F. G. Hayden. 1998. Enterovirus meningitis in adults. Clin. Infect. Dis. 27:896898.
66. Rotbart, H. A.,, and A. D. Webster. 2001. Treatment of potentially life-threatening enterovirus infections with pleconaril. Clin. Infect. Dis. 32:228235.
67. Santhosh, S. R.,, M. M. Parida,, P. K. Dash,, A. Pateriya,, B. Pattnaik,, H. K. Pradhan,, N. K. Tripathi,, S. Ambuj,, N. Gupta,, P. Saxena, and, P. V. Lakshmana Rao. 2007. Development and evaluation of SYBR Green I-based one-step real-time RT-PCR assay for detection and quantitation of Japanese encephalitis virus. J. Virol. Methods 143:7380.
68. Sawyer, M. H. 1999. Enterovirus infections: diagnosis and treatment. Pediatr. Infect. Dis. J. 18:10331039.
69. Scheld, W. M.,, R. J. Whitley, and, C. M. Marra (ed.). 2004. Infections of the Central Nervous System, 3rd ed. Lippincott Williams & Wilkins, Philadelphia, Pa.
70. Schmugge, M.,, R. Lauener,, R. A. Seger,, T. Gungor, and, W. Bossart. 1999. Chronic enteroviral meningoencephalitis in X-linked agammaglobulinaemia: favourable response to anti-enteroviral treatment. Eur. J. Pediatr. 158:10101011. (Letter.)
71. Schuster, F. L.,, C. Glaser,, S. Honarmand,, J. H. Maguire, and, G. S. Visvesvara. 2004. Balamuthia amebic encephalitis risk, Hispanic Americans. Emerg. Infect. Dis. 10:15101512.
72. Sejvar, J. J. 2006. The evolving epidemiology of viral encephalitis. Curr. Opin. Neurol. 19:350357.
73. Sejvar, J. J. 2007. The long-term outcomes of human West Nile virus infection. Clin. Infect. Dis. 44:16171624.
74. Solomon, T. 2006. Control of Japanese encephalitis—within our grasp? N. Engl. J. Med. 355:869871.
75. Stanberry, L. R.,, S. A. Floyd-Reising,, B. L. Connelly,, S. J. Alter,, M. J. Gilchrist,, C. Rubio, and, M. G. Myers. 1994. Herpes simplex viremia: report of eight pediatric cases and review of the literature. Clin. Infect. Dis. 18:401407.
76. Steiner, I.,, H. Budka,, A. Chaudhuri,, M. Koskiniemi,, K. Sainio,, O. Salonen, and, P. G. Kennedy. 2005. Viral encephalitis: a review of diagnostic methods and guidelines for management. Eur. J. Neurol. 12:331343.
77. Stuve, O.,, and S. S. Zamvil. 1999. Pathogenesis, diagnosis, and treatment of acute disseminated encephalomyelitis. Curr. Opin. Neurol. 12:395401.
78. Suja, M. S.,, A. Mahadevan,, C. Sundaram,, J. Mani,, B. C. Sagar,, T. Hemachudha,, S. Wacharapluesadee,, S. N. Madhusudana, and, S. K. Shankar. 2004. Rabies encephalitis following fox bite—histological and immunohistochemical evaluation of lesions caused by virus. Clin. Neuropathol. 23:271276.
79. Sutton, J. M.,, J. Dickinson,, J. T. Walker, and, N. D. Raven. 2006. Methods to minimize the risks of Creutzfeldt-Jakob disease transmission by surgical procedures: where to set the standard? Clin. Infect. Dis. 43:757764.
80. Tschampa, H. J.,, K. Kallenberg,, H. Urbach,, B. Meissner,, C. Nicolay,, H. A. Kretzschmar,, M. Knauth, and, I. Zerr. 2005. MRI in the diagnosis of sporadic Creutzfeldt-Jakob disease: a study on inter-observer agreement. Brain 128:20262033.
81. Valduss, D.,, D. L. Murray,, P. Karna,, K. Lapour, and, J. Dyke. 1993. Use of intravenous immunoglobulin in twin neonates with disseminated coxsackie b1 infection. Clin. Pediatr. 32:561563.
82. Varki, A. P.,, and P. Puthuran. 1979. Value of second lumbar puncture in confirming a diagnosis of aseptic meningitis. A prospective study. Arch. Neurol. 36:581582.
83. Wang, S. M.,, H. Y. Lei,, L. Y. Su,, J. M. Wu,, C. K. Yu,, J. R. Wang, and, C. C. Liu. 2007. Cerebrospinal fluid cytokines in enterovirus 71 brain stem encephalitis and echovirus meningitis infections of varying severity. Clin. Microbiol. Infect. 13:677682.
84. Whitley, R. J.,, C. G. Cobbs,, C. A. Alford, Jr.,, S. J. Soong,, M. S. Hirsch,, J. D. Connor,, L. Corey,, D. F. Hanley,, M. Levin, and, D. A. Powell for the NIAID Collaborative Antiviral Study Group. 1989. Diseases that mimic herpes simplex encephalitis. Diagnosis, presentation, and outcome. JAMA 262:234239.
85. Whitley, R. J.,, and J. W. J. Gnann. 1992. Acyclovir: a decade later. N. Engl. J. Med. 327:782793.
86. Whitley, R. J.,, N. Macdonald,, D. M. Ascher, and the Committee on Infectious Diseases. 2000. Technical report: transmissible spongiform encephalopathies: a review for pediatricians. Pediatrics 106:11601165.

Tables

Generic image for table
TABLE 1

DNA viruses: type of disease, epidemiological data, and pathogenesis of viral infections of the CNS

Citation: Cassady K, Whitley R. 2009. Viral Central Nervous System Infections, p 29-44. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch3
Generic image for table
TABLE 2

RNA viruses: type of disease, epidemiological data, and pathogenesis of viral infections of the CNS

Citation: Cassady K, Whitley R. 2009. Viral Central Nervous System Infections, p 29-44. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch3
Generic image for table
TABLE 3

Nonviral etiologies for encephalitis and meningitis

Citation: Cassady K, Whitley R. 2009. Viral Central Nervous System Infections, p 29-44. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch3

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error