1887

13 Encephalitis in Immunocompromised Patients

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

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

13 Encephalitis in Immunocompromised Patients, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817831/9781555812409_Chap13-1.gif /docserver/preview/fulltext/10.1128/9781555817831/9781555812409_Chap13-2.gif

Abstract:

The immunological defects are variable and include B-cell failure in X-linked agammaglobulinemia and helper T-cell ablation in AIDS. In other cases, such as allograft recipients, the defects are rather more generalized. In all entities considered in this chapter the clinician must balance management of the central nervous system (CNS) disease with the underlying, or associated, systemic disease. Progressive multifocal leukoencephalopathy (PML) is caused by a polyomavirus, one of two varieties of papovaviruses, the other being papillomaviruses. The diagnosis of PML in AIDS should be suspected in a patient with significant suppression of cell-mediated immunity, usually below 100 CD4 lymphocytes per mm3, in whom a subacute onset of multifocal neurological deficits is observed. Congenital infection can be associated with microcephaly and periventricular calcifications in newborns. The subependymal region is a particular locus of congenital infection. Cytomegalovirus (CMV) is the largest of the herpesviruses and takes its name from the characteristic cell enlargement with owl's eye intranuclear viral inclusions that it produces. Neurological involvement with CMV infection in neonates is almost always due to congenital infection, with the risk of clinical disease being great when maternal infection occurs during the first trimester of pregnancy. Cell-mediated immunity plays the predominant role in control of many viral infections. Most of the encephalitic syndromes, in distinction to the leukoencephalitic syndromes, reflect reactivation of viruses in the herpesvirus family. Following death from an encephalitis associated with progressive impairment of mental status and amnesic symptoms, HHV-6-bearing cells were demonstrated in two regions of the brain by immunohistochemistry.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of FIGURE 13.1
FIGURE 13.1

Close-up view of coronal slice through the brain from a case of PML. The characteristic lesions are present at the junction between cerebral cortex and white matter (arrows).

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.2
FIGURE 13.2

PML. Lower-power view of section of cerebral cortex and subcortical white matter stained for myelin. Multiple small foci of myelin pallor are present near the junction between cortex and white matter. Luxol fast blue stain.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.3
FIGURE 13.3

PML. Area at the margin of a demyelinated zone. Several oligodendrocyte nuclei are enlarged and hyperchromatic, with basophilic intranuclear inclusions (*). Hematoxylin and eosin stain.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.4
FIGURE 13.4

PML. Section stained for the enzyme carbonic anhydrase isoenzyme II, a marker of oligodendrocytes. Some oligodendrocytes show an intense reaction indicating a reactive state. Counterstained with hematoxylin.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.5
FIGURE 13.5

PML. Low-power view of section of cerebellar cortex showing patchy granule cell loss (outlined). Purkinje cells are also depleted. Hematoxylin and eosin stain.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.6
FIGURE 13.6

Electron micrograph of a biopsy from a case of PML showing a nucleus containing both spherical and filamentous polyomavirus particles. Uranyl acetate and lead citrate stain. Courtesy of A. M. Field.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.7
FIGURE 13.7

MRI of PML. Axial proton density image shows scattered areas of hyperintensity, predominantly in white matter but with some possible gray matter involvement. Mild mass effect is present. Courtesy of Judith Donovan Post, University of Miami School of Medicine.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.8
FIGURE 13.8

Congenital CMV infection: (a) cerebral section showing microcephaly and ventricular enlargement; (b) low-power view of ependymitis from the same case.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.9
FIGURE 13.9

Congenital CMV. Demonstration of CMV antigen in inclusion-bearing cells in subependymal position.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.10
FIGURE 13.10

CMV. Ventriculoependymitis with foci of necrosis in nearby dentate nucleus of the cerebellum (arrows). Luxol fast blue-cresyl violet stain.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.11
FIGURE 13.11

MRI of CMV ependymitis. T1-weighted coronal image with contrast demonstrating ependymal enhancement around the third and lateral ventricles. Courtesy of Gordon Sze, Yale University School of Medicine.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 13.12
FIGURE 13.12

Multinucleate giant cell in the hypothalamus from a case of IME. Immunostain with measles antibody is immunopositive in the nuclei. Counterstained with hematoxylin.

Citation: Booss J, Esiri M. 2003. 13 Encephalitis in Immunocompromised Patients, p 221-236. In Viral Encephalitis in Humans. ASM Press, Washington, DC. doi: 10.1128/9781555817831.ch13
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555817831.chap13
1. Agamanolis, D. R.,, J. S. Tan,, and D. L. Parker. 1979. Immunosuppressive measles encephalitis in a patient with a renal transplant. Arch. Neurol. 36:686690.
2. Aicardi, J ., , F. Goutieres,, M.-L. Arsenio-Nunes,, and P. Lebon. 1977. Acute measles encephalitis in children with immunosuppression. Pediatrics 59:232239.
3. Aksamit, A. J ., Jr.,, and P. C. de Groen. 1995. Cyclosporinerelated leukoencephalopathy and PML in a liver transplant recipient. Transplantation 60:874876.
4. Anduze-Faris, B. M.,, A.-M. Fillet,, J . Gozlan,, R. Lancar,, N. Boukli,, J . Gasnault,, E. Caumes,, J . Livartowsky,, S. Matheron,, C. Leport,, D. Salmon,, D. Costagliota,, and C. Katlama. 2000. Induction and maintenance therapy of cytomegalovirus central nervous system infection in HIV-infected patients. AIDS 14:517524.
5. Arribas, J. R.,, G. A. Storch,, D. B. Clifford,, and A. C. Tselis. 1996. Cytomegalovirus encephalitis. Ann. Intern. Med. 125:577587.
6. Astrom, K.-E.,, E. L. Mancall,, and E. P. Richardson Jr. 1958. Progressive multifocal leukoencephalopathy. A hitherto unrecognized complication of chronic lymphatic leukemia and Hodgkin's disease. Brain 81:93111, with 14 plates.
7. Atkinson, W.,, and C. S. Wolfe (ed.). 2002. Poliomyelitis, p. 7182. In Epidemiology and Prevention of Vaccine-Preventable Disease, 7th ed. U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, Ga.
8. Back, E.,, C. Hoglund,, and H. O. Malmulund. 1977. Cytomegalovirus infection associated with severe encephalitis. Scand. J. Infect. Dis. 9:141143.
9. Baczko, K.,, U. G. Liebert,, R. Cattaneo,, M. A. Billeter,, R. R Roos,, and V. ter Meulen. 1988. Restriction of measles virus gene expression in measles inclusion body encephalitis. J. Infect. Dis. 158:144150.
10. Bakshi, N.,, J. Lawson,, R. Hanson,, C. Ames,, and H. V. Vinters. 1996. Fatal mumps meningoencephalitis in a child with severe combined immunodeficiency after bone marrow transplantation. J. Child. Neurol. 11:159162.
11. Bell, J . E. 1998. The neuropathology of adult HIV infection. Rev. Neurol. (Paris) 154:816829.
12. Berger, J . R.,, and E. O. Major. 1999. Progressive multifocal leucoencephalopathy. Semin. Neurol. 19:193200.
13. Berger, J . R.,, and L. Mucke. 1988. Prolonged survival and partial recovery in AIDS-associated progressive multifocal leukoencephalopathy. Neurology 38:10601065.
14. Berger, J . R.,, B. Kaszovitz,, J . D. Post,, and G. Dickinson. 1987. Progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection. A review of the literature with a report of sixteen cases. Ann. Intern. Med. 107:7887.
15. Bitnun, A.,, P. Shannon,, A. Durward,, P. A. Rota,, W. J . Bellini,, C. Graham,, E. Wang,, E. L. Ford-Jones,, P. Cox,, L. Becker,, M. Fearon,, M. Petric,, and R. Tellier. 1999. Measles inclusionbody encephalitis caused by the vaccine strain of measles virus. Clin. Infect. Dis. 29:855861.
16. Bixler, G. S., Jr.,, and J. Booss. 1981. Adherent spleen cells from mice acutely infected with cytomegalovirus suppress the primary antibody response in vitro. J . Immunol. 127:12941299.
17. Bofill-Mas, S.,, and R. Girones. 2001. Excretion and transmission of JCV in human populations. J. Neurovirol. 7:345349.
18. Bollen, A. E.,, H. Haaxma-Reiche,, A. N. Wartan,, and A. P. Krikke. 2001. Amnestic syndrome after lung transplantation by human herpes virus-6 encephalitis. J. Neurol. 248:619620.
19. Bonham, C. A.,, E. A. Dominguez,, M. B. Fukui,, D. L. Paterson,, G. A. Pankey,, M. M. Wagener,, J . J . Fung,, and N. Singh. 1998. Central nervous system lesions in liver transplant recipients. Transplantation 66:15961604.
20. Booss, J. , and M. M. Esiri. 1986. Viral Encephalitis: Pathology, Diagnosis and Management. Blackwell Scientific Publications, Oxford, United Kingdom.
21. Booss, J .,, P. R. Dann,, B. R. Griffith,, and J. H. Kim. 1988. Glial nodule encephalitis in the guinea pig: serial observations following cytomegalovirus infection. Acta Neuropathol. 75:465473.
22. Boulton-Jones, J. R.,, C. Fraser-Moodie,, and S. D. Ryder. 2001. Long term survival from progressive multifocal leukoencephalopathy after liver transplantation. J. Hepatol. 35:828829.
23. Brooks, B. R.,, and D. L. Walker. 1984. Progressive multifocal leukoencephalopathy. Neurol. Clin. 2:299313.
24. Budka, H.,, S. Urbanitis,, P. P. Liberski,, S. Eichinger,, and T. Papow-Kraupp. 1996. Subacute measles virus encephalitis: a new and fatal opportunistic infection in a patient with AIDS. Neurology 46:586587.
25. Chadwick, D. W.,, S. Martin,, R. H. Buxton,, and A. H. Tomlinson. 1982. Measles virus and subacute neurological disease: an unusual presentation of measles inclusion body encephalitis. J . Neurol. Neurosurg. Psychiatr. 45:680684.
26. Chen, Y.,, C. Scieux,, V. Garrait,, G. Socie,, V. Rocha,, J.-M. Molina,, D. Thouvenot,, E. Morfin,, L. Hocqueloux,, L. Garderet,, H. Esperou,, F. Selimi,, A. Devergie,, G. Leleu,, M. Aymard,, E. Morinet,, E. Gluckman,, and P. Ribaud. 2000. Resistant herpes-simplex virus type 1 infection: an emerging concern after allogenic stem cell transplantation. Clin. Infect. Dis. 31:927935.
27. Ch'ien, L. T.,, R. A. Price,, K. G. Murti,, and J. Ochs. 1983. Fatal subacute immunosuppressive measles encephalitis (SIME) in children with acute lymphocytic leukemia–clinical, electroencephalographic, and computerized tomographic scan features. Clin. Electroenceph. 14:214220.
28. Chretien, E.,, L. Belec,, L. Wingerstmann,, P. de Truchis,, M. Baudrimont, C. Perronne, and E Gray. 1997. [Central nervous system infection due to Herpes simplex virus in AIDS.] Arch. Anat. Cytol. Pathol. 45:153158.
29. Cinque, P.,, L. Vago,, M. Brytting,, A. Castagna,, A. Accordini,, V.-A. Sundquist,, N. Zanchetta,, A. D. Monteforts,, B. Wahren,, A. Lazzarin,, and A. Linde. 1992. Cytomegalovirus infection of the central nervous system in patients with AIDS: diagnosis by DNA amplification from cerebrospinal fluid. J. Infect. Dis. 166:14081411.
30. Clifford, D. B . 1999. Opportunistic viral infections in setting of human immunodeficiency virus. Semin. Neurol. 19:185192.
31. Clifford, D. B.,, C. Yiannoutsos,, M. Glicksman,, D. M. Simpson,, E. J . Singer,, P. J . Piliero,, C. M. Marra,, G. S. Francis,, J. C. McArthur,, K. L. Tyler,, A. C. Tselis,, and N. E. Hyslop. 1999. HAART improves prognosis in HIV-associated progressive multifocal leucoencephalopathy. Neurology 52:623625.
32. Cohen, B. A. 1996. Prognosis and response to therapy of cytomegalovirus encephalitis and meningomyelitis in AIDS. Neurology 46:444450.
33. Cohen, B. A.,, J . C McArthur,, S. Grohman,, B. Patterson,, and J . D. Glass. 1993. Neurologic prognosis of cytomegalovirus polyradiculomyelopathy in AIDS. Neurology 43:493499.
34. Coley, S. C.,, H. R. Jager,, R. M. Szydlo,, and J. M. Goldman. 1999. CT and MRI manifestations of central nervous system infection following allogenic bone marrow transplantation. Clin. Radiol. 54:390397.
35. Cunningham, C. K.,, C. A. Bonville,, H. D. Ochs,, K. Seyama,, R. 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.
36. Cunningham-Rundles, C. 1989. Clinical and immunologic analyses of 103 patients with common variable immunodeficiency. J. Clin. Immunol. 9:2233.
37. Davies, J. A.,, J . T. Hughes,, and J . R. Oppenheimer. 1973. Richardson's disease (progressive multifocal leukoencephalopathy). Q.J. Med. 42:481501.
38. Degener, A. M.,, V. Pietropaolo,, C. Di Taranto,, V. Rizzuti,, F. Ameglio,, P. Cordiali Fei,, E. Caprilli,, B. Capitanio,, L. Sinibaldi,, and N. Orsi. 1997. Detection of JC and BK viral genome in specimens of HIV-1 infected subjects. New Microbiol. 20:115122.
39. De Luca, A.,, M. L. Giancola,, A. Ammassari,, S. Grisetti,, A. Cingolani,, D. Larussa,, L. Alba,, R. Murri,, G. Ippolito,, R. Cauda,, A. Monforte,, and A. Antinori. 2001. Potent antiretroviral therapy with or without cidofovir for AIDS-associated progressive multifocal leukoencephalopathy: extended followup of an observational study. J. Neurovirol. 7:364368.
40. Dorries, K.,, R. T. Johnson,, and V. ter Meulen. 1979. Detection of polyoma virus DNA in PML-brain tissue by (in situ) hybridization. J. Gen. Virol. 42:4957.
41. Drobyski, W. R.,, K. K. Knox,, D . Majewski,, and D. R. Carrigan. 1994- Brief report: fatal encephalitis due to variant B human herpesvirus-6 infection in a bone marrow transplant recipient. N. Engl. J. Med. 330:13361360.
42. Drysdale, H. C.,, L. E. Jones,, D. R. Oppenheimer,, and A. H. Tomlinson. 1976. Measles inclusion-body encephalitis in a child with treated acute lymphoblastic leukaemia. J. Clin. Pathol. 29:865872.
43. Erlendsson, K.,, T. Swartz,, and J . M. Dwyer. 1985. Successful reversal of echovirus encephalitis in X-linked hypogammaglobulinemia by the intraventricular administration of immunoglobulin. N. Engl. J. Med. 312:351353.
44. Esiri, M. M.,, D. R. Oppenheimer,, B. Brownell,, and M. Haire. 1982. Distribution of measles antigen and immunoglobulincontaining cells in the CNS in subacute sclerosing panencephalitis and atypical measles encephalitis. J. Neurol. Sci. 53:2943.
45. Flood, J .,, W. L. Drew,, R. Miner,, D. Jekic-McMullen,, L. P. Shen,, J. Kolberg,, J. Garvey,, S. Follansbee,, and M. Poscher. 1997. Diagnosis of cytomegalovirus (CMV) polyradiculopathy and documentation of in vivo anti-CMV activity in cerebrospinal fluid by using branched DNA signal amplification and antigen assays. J. Infect. Dis. 176:348352.
46. Gallia, G. L.,, S. A. Houff,, E. O. Major,, and K. Khalili. 1997. Review: JC virus infection of lymphocytes-revisited. J. Infect. Dis. 176:16031609.
47. Gasnault, J .,, Y. Taoufik,, C. Goujard,, P. Kousignian,, K. Abbed,, F. Boue,, E. Dussaix,, and J. F. Delfraissy. 1999. Prolonged survival without neurological improvement with AIDS-related progressive multifocal leukoencephalopathy on potent combined antiretroviral therapy. J. Neurovirol. 7:421429.
48. Gasnault, J.,, P. Kousignian,, M. Kahraman,, J. Rahoifjaon,, S. Matheron,, J . F. Delfraissy,, and Y. Taoufik. 2001. Cidofovir in AIDS-associated progressive multifocal leukoencephalopathy: a monocenter observational study with clinical and JC virus load monitoring. J. Neurovirol. 7:375381.
49. Gazzola, P.,, L . Cocito,, E . Capello,, L . Roccatagliata,, M. Canepa,, and G. L . Mancardi. 1999. Subacute measles encephalitis in a young man immunosuppressed for ankylosing spondylitis. Neurology 52:10741077.
50. Geschwind, M. D.,, R. I. Skolasky,, W. S. Royal,, and J. C. McArthur. 2001. The relative contributions of HAART and alpha-interferon for therapy of progressive multifocal leukoencephalopathy in AIDS. J. Neurovirol. 7:353357.
51. Giobbia, M.,, A. Carniato,, P. G. Scotton,, G. C Marchiori,, and A. Vaglia. 1999. Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient. Infection 27:228230.
52. Gozlan, J . J .,, M. Salord,, E. Roullet, M. Baudrimont,, F. Caburet,, O. Picard,, M. C. Meyohas,, C. Duvivier,, C. Jacomet,, and J. C. Petit. 1992. Rapid detection of cytomegalovirus DNA in cerebrospinal fluid of AIDS patients with neurologic disorders. J. Infect. Dis. 166:14161421.
53. Grassi, M. P.,, F. Clerici,, C. Perin,, A. D'Arminio Monforte,, L. Vago,, M. Borella,, R. Boldorini,, and A. Mangoni. 1998. Microglial nodular encephalitis and ventriculoencephalitis due to cytomegalovirus infection in patients with AIDS: two distinct clinical patterns. Clin. Infect. Dis. 27:504508.
54. Greenlee, J. E., 1997. Polyomaviruses, p. 549567. In D. D. Richman,, R. J. Whitley,, and F. G. Hayden (ed.), Clinical Virology. Churchill Livingstone, New York, N.Y.
55. Griffith, B. P.,, and J. Booss. 1994. Neurologic infections of the fetus and newborn. Neurol. Clin. 12:541564.
56. Gullotta, E.,, T. Masini,, G. Scarlato,, and K. Kuchelmeister. 1992. Progressive multifocal leukoencephalopathy and gliomas in a HIV-negative patient. Pathol. Res. Pract. 188:964972.
57. Hall, C. D.,, U. Dafni,, D. Simpson,, D. Clifford,, P. E. Wetherill,, B . Cohen,, J . McArthur,, H. Hollander,, C. Yainnoutsos,, E. Major,, L. Millar,, J . Tlmpone, and the AIDS Clinical Trials Group 243 Team. 1998. Failure of cytarabine in progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection. N. Engl. J. Med. 338:13451351.
58. Hata, A.,, H. Asanuma,, M. Rinki,, M. Sharp,, R. M. Wong,, K. Blume,, and A. M. Arvin. 2002. Use of an inactivated varicella vaccine in recipients of hematopoietic-cell transplants. N. Engl. J. Med. 347:2634.
59. Hermaszewski, R. A.,, and A. D. B . Webster. 1993. Primary hypogammaglobulinemia: a survey of clinical manifestations and complications. Q. J. Med. 86:3142.
60. Hirst, L. W.,, A. W. Clark,, J . S. Wolinsky,, D. S. Zee,, H. Kaizer,, N. R. Miller,, P. J . Tutschka,, and G. W. Santos. 1983. Downbeat nystagmus. A case report of herpetic brain stem encephalitis. J. Clin. Neuro-ophthalmol. 3:245249.
61. Holland, N. R.,, C. Power,, V. P. Matthews,, J. D. Glass,, M. Forman,, and J. C. McArthur. 1994. Cytomegalovirus encephalitis in acquired immunodeficiency syndrome (AIDS). Neurology 44:507514.
62. Hon, J .,, P. N. Jensen,, and E. O. Major,. 2000. The biology and clinical consequence of JC virus infection in the human brain-progressive multifocal leucoencephalopathy, p. 205222. In P. K. Peterson, and J. S. Remington (ed.), New Concepts in the Immunopathogenesis of CNS Infections. Blackwell Science, Oxford, United Kingdom.
63. Horton, B.,, R. W. Price,, and D. Jimenez. 1981. Multifocal varicella-zoster virus leukoencephalitis temporally remote from herpes zoster. Ann. Neurol. 9:251266.
64. Hughes, I.,, M. E. M. Jenney,, R. W. Newton,, D. J . Morris,, and P. E. Klapper. 1993. Measles encephalitis during immunosuppressive treatment for acute lymphoblastic leukemia. Arch. Dis. Child. 68:775778.
65. Itoyama, Y.,, H. D. Webster,, N. H. Sternberger,, E. P. Richardson, Jr.,, D. L. Walker,, R. H. Quarles,, and B. L. Padgett. 1982. Distribution of papovavirus, myelin-associated glycoprotein, and myelin basic protein in progressive multifocal leukoencephalopathy lesions. Ann. Neurol. 11:396407.
66. Johnson, R. 1998. Viral Infections of the Nervous System, 2nd ed. Lippincott-Raven Press, Philadelphia, Pa.
67. Kalayjian, R. C.,, M. L . Cohen,, R. A. Bonomo,, and T. P. Flanigan. 1993. Cytomegalovirus ventriculoencephalitis in AIDS. A syndrome with distinct clinical and pathological features. Medicine 72:6777.
68. Kim, Y. S.,, and H. Hollander. 1993. Polyradiculopathy due to cytomegalovirus: report of two cases in which improvement occurred after prolonged therapy and review of the literature. Clin. Infect. Dis. 17:3237.
69. Kipps, A.,, G. Dick,, and J . W. Moodie. 1983. Measles and the central nervous system. Lancet ii:14061410.
70. Lederman, H. M.,, and J . A. Winkelstein. 1985. X-linked agammaglobulinemia: an analysis of 96 patients. Medicine 64:145156.
71. Levy, J .,, T. Espanol-Boren,, C. Thomas,, A. Fischer,, P. Tova,, P. Bordigoni,, I. Resnick,, A. Faath,, M. Baer,, L. Gomez,, E. A. M. Sanders,, M.-D. Tabone,, D. Plantaz,, A. Etzioni,, V. Monafo,, M. Abinun,, L. Hammarstrom,, T. Abrahamsen,, A. Jones,, A. Finn,, T. Klemola,, E. DeVries,, O. Sanal,, M. C. Peitsch,, and L. D. Notarangelo. 1997. Clinical spectrum of x-linked hyper IgM syndrome. J . Pediatr. 131:4754.
72. Love, S.,, and C. A. Wiley,. 2002. Viral diseases, p. 1105. In D. I. Graham, and P. L. Lantos (ed.), Greenfield's Neuropathology. Arnold, London, United Kingdom.
73. MacGinley, R.,, P. B . Bartley,, T. Sloots,, and D. W. Johnson. 2001. Epstein-Barr virus encephalitis in a renal allograft recipient diagnosed by polymerase chain reaction on cerebrospinal fluid and successfully treated with ganciclovir. Nephrol. Dial. Transplant. 16:197198.
74. Marra, C. M.,, N . Rajicic,, D. E. Barker,, B. Cohen,, D. Clifford,, M. J . D. Post,, A. Ruiz,, B . C . Bowen,, M.-L. Huang,, J . Queen- Baker,, J . Anderson,, S. Kelly,, S. Shriver, and the Adult AIDS Clinical Trials Group 363. 2002. A pilot study of Cidofovir for progressive multifocal leukoencephalopathy in AIDS. AIDS 16:17911797.
75. Maschke, M.,, U. Dietrich,, M. Prumbaum,, O. Kastrup,, B. Turowski,, U. W. Schaefer,, and H. C Diener. 1999. Opportunistic CNS infection after bone marrow transplantation. Bone Marrow Transplant. 23:11671176.
76. Maschke, M.,, O. Kastrup,, and H.-C. Diener. 2002. CNS manifestations of cytomegalovirus infections. Diagnosis and treatment. CNS Drugs 16:303315.
77. Masdeu, J . C.,, C. B . Small,, L . Weiss,, C. M. Elkin,, J . Liena,, and R. Mesa-Tejada. 1988. Multifocal cytomegalovirus encephalitis in AIDS. Ann. Neurol. 23:9799.
78. Masliah, E.,, R. M. DeTeresa,, M. E. Mallory,, and L. A. Hansen. 2000. Changes in pathological findings at autopsy in AIDS cases for the last 15 years. AIDS 14:6974.
79. McKinney, R. E., Jr.,, S. L. Katz,, and C. M. Wilfert. 1987. Chronic enteroviral meningoencephalitis in agammaglobulinemic patients. Rev. Infect. Dis. 9:334356.
80. McQuaid, S.,, S. L. Cosby,, K. Koffi,, M. Honde,, J . Kirk,, and S. B. Lucas. 1998. Distribution of measles virus in the central nervous system of HIV-seropositive children. Acta Neuropathol. (Berlin) 96:637642.
81. Mease, P. J.,, H. D. Ochs,, and R. J. Wedgwood. 1981. Successful treatment of echovirus meningoencephalitis and myositis-fasciitis with intravenous immune globulin therapy in a patient with X-linked agammaglobulinemia. N. Engl. J. Med. 304:12781281.
82. Miles, C.,, W. Hoffman,, C. W. Lai,, and J. W. Freeman. 1993. Cytomegalovirus-associated transverse myelitis. Neurology 43:21432145.
83. Miller, J. R.,, R. E. Barrett,, C. B. Britton,, M. L. Tapper,, G. S. Bahr,, P. J . Bruno,, M. D. Marquart,, A. R Hays,, J . G. Mo Murtry III,, J. B. Weissman,, and M. S. Bruno. 1982. Progressive multifocal leukoencephalopathy in a male homosexual with T-cell immune deficiency. N. Engl. J. Med. 307:14361438.
84. Mohrmann, R. L.,, V. Mah,, and H. V. Vinters. 1990. Neuropathology findings after bone marrow transplantation. An autopsy study. Hum. Pathol. 21:630639.
85. Monaco, M. C.,, P. N . Jensen,, J . Hou,, L. C. Durham,, and E. O. Major. 1998. Detection of JC virus DNA in human tonsil tissue: evidence for site of initial viral infection. J . Virol. 72:99189923.
86. Morgello, S.,, E.-S. Cho,, S. Nielsen,, O. Devinsky,, and C. K. Petito. 1987. Cytomegalovirus encephalitis in patients with acquired immunodeficiency syndrome: an autopsy study of 30 cases and a review of the literature. Hum. Pathol. 18:289297.
87. Morris, C. S.,, M. M. Esiri,, T. J . Sprinkle,, and N. Gregson. 1994. Oligodendrocyte reactions and cell proliferation markers in human demyelinating diseases. Neuropathol Appl. Neurobiol. 20:272281.
88. Mussini, C.,, N. Mongiardo,, G. Manicardi,, F. Trenti,, A. Alessandri,, F. Paolillo,, A. Catania,, M. Portolani,, M. Pecorari,, V. Borghi,, G. Ficarra,, A. Cossarizza,, and B. DeRienzo. 1997. Relevance of clinical and laboratory findings in the diagnosis of cytomegalovirus encephalitis in patients with AIDS. Eur. J. Clin. Microbiol. Infect. Dis. 16:437444.
89. Mustafa, M. M.,, S. D. Weitman,, N. J . Winick,, W. J . Bellini,, C. F. Timmons,, and J . D. Siegel. 1993. Subacute measles encephalitis in the young immunocompromised host: report of the cases diagnosed by polymerase chain reaction and treated with ribavirin and review of the literature. Clin. Infect. Dis. 16:654660.
90. Navia, B. A.,, E.-S. Cho,, C. K. Petito,, and R. W. Price. 1986a. The AIDS dementia complex: I. Clinical features. Ann. Neurol. 19:517524.
91. Navia, B. A.,, E.-S. Cho,, C. K. Petito,, and R. W. Price. 1986b. The AIDS dementia complex: II. Neuropathology. Ann. Neurol. 19:525535.
92. Padgett, B. L.,, D. L. Walker,, G. M. Zu Rhein,, R. J . Eckroade,, and G. H. Dessell. 1971. Cultivation of papova-like virus from human brain with progressive multifocal leukoencephalopathy. Lancet i:12571260.
93. Patel, R.,, and C. V. Paya. 1997. Infections in solid-organ transplant recipients. Clin. Microbiol. Rev. 10:86124.
94. Pevear, D. C.,, T. M. Tull,, M. E . Seipel,, and J . M. Groarke. 1999. Activity of pleconaril against enteroviruses. Antimicrob. Agents Chemother. 43:21092115.
95. Post, M. J . D.,, C. Yiannoutsos,, D. Simpson,, J . Booss,, D. B. Clifford,, B. Cohen,, J . K. McArthur,, C. D. Hall, and the AIDS Clinical Trials Group, 243 Team. 1999. Progressive multifocal leukoencephalopathy in AIDS: are there any MR findings useful to patient management and predictive of patient survival? Am. J . Neuroradiol. 20:18961906.
96. Power, C.,, S. D. Poland,, K. H. Kassim,, J. C. E. Kaufmann,, and G. P. A. Rice. 1990. Encephalopathy in liver transplantation: neuropathology and CMV infection. Can. J. Neurol. Sci. 17:378381.
97. Quartier, P.,, S. Foray,, J.-L. Casanova,, I. H. Rainsard,, S. Blanche,, and A. Fischer. 2000. Enteroviral meningoencephalitis in x-linked agammaglobulinemia: intensive immunoglobulin therapy and sequential viral detection in cerebrospinal fluid by polymerase chain reaction. Pediatr. Infect. Dis. J. 19:11061108.
98. Ribalta, T.,, A. J . Martinez,, P. Jares,, J. Muntane,, R. Miquel,, X. Claramonte,, and A. Cardesa. 2002. Presence of occult cytomegalovirus infection in the brain after orthotopic liver transplantation. An autopsy study of 83 cases. Virchows Arch. 440:166171.
99. Roos, R. P.,, M. C . Graves,, R. L . Woliman,, R. R. Chilcote,, and J . Nixon. 1981. Immunologic and virologic studies of measles inclusion body encephalitis in an immunocompromised host: the relationship to subacute sclerosing panencephalitis. Neurology 31:12631270.
100. Rotbart, H. A.,, J . P. Kinsella,, and R. L. Wasserman. 1990. Persistent enterovirus infection in culture negative meningoencephalitis: demonstration by enzymatic RNA amplification. J. Infect. Dis. 161:787791.
101. Rotbart, H. A.,, and A.B.D. WebsterforthePleconarilTreatmentRegistryGroup. 2001. Treatment of potentially life threatening enterovirus infection with pleconaril. Clin. Infect. Dis. 32:228235.
102. Rudge, P.,, A. D. B. Webster,, T. Revesz,, T. Warner,, T. Espanol,, C. Cunningham-Rundles,, and N. Hyman. 1996. Encephalomyelitis in primary hypogammaglobulinaemia. Brain 119:115.
103. Scaravilli, F.,, and F. Gray,. 1993. Opportunistic infections, p. 49120. In F. Gray (ed.), Atlas of the Neuropathology of HIV Infection. Oxford University Press, Oxford, United Kingdom.
104. Schmitz, H.,, and G. Enders. 1977. Cytomegalovirus as a frequent cause of Guillain-Barre syndrome. J. Med. ViroLl. 1:2127.
105. Schmugge, M.,, R. Lauener,, W. Bossart,, R. A. Seger,, and T. Gungor. 1999. Chronic enteroviral meningoencephalitis in x-linked agammaglobulinaemia: favorable response to antienteroviral treatment. Eur. J. Pediatr. 158:10101011.
106. Schneck, S. A. 1965. Neuropathological features of human organ transplantation. I. Probable cytomegalovirus infection. J . Neuropathol. Exp. Neurol. 24:415429.
107. Setinek, U.,, E. Wondrusch,, K. Jellinger,, A. Steuer,, M. Drlicek,, W. Grisold,, and F. Lintner. 1995. Cytomegalovirus infection of the brain in AIDS: a clinicopathological study. Acta Neuropathol. 90:511515.
108. Shein, H. M. 1967. Neoplastic transformation induced by simian virus 40 in Syrian hamster neuroglial and meningeal cell cultures. Arch. Gesamte Virusforsch. 22:122142.
109. Sia, I. G.,, and R. Patel. 2000. New strategies for prevention and therapy of cytomegalovirus infection and disease in solid-organ transplant recipients. Clin. Microbiol. Rev. 13:83121.
110. Sima, A. A.,, S. D. Finkelstein,, and D. R. McLachlan. 1983. Multiple malignant astrocytomas in a patient with spontaneous progressive multifocal leukoencephalopathy. Ann. Neurol. 14:183188.
111. Singh, N.,, A. Bonham,, and M. Fukui. 2000. Immunosuppressiveassociated leukoencephalopathy in organ transplant recipients. Transplantation 69:467472.
112. Snider, W. D.,, D. M. Simpson,, S. Nielsen,, J . W. Gold,, C. E. Metroka,, and J . B . Posner. 1983. Neurological complications of acquired immune deficiency syndrome. Analysis of fifty patients. Ann. Neurol. 14:403418.
113. So, Y. T.,, and R. K. Olney. 1994- Acute lumbosacral polyradicuiopathy in acquired immunodeficiency syndrome: experience in 23 patients. Ann. Neurol. 135:5358.
114. Studahl, M.,, A. Ricksten,, T. Sandberg,, and T. Bergstrom. 1992. Cytomegalovirus encephalitis in four immunocompetent patients. Lancet 340:10451046.
115. Suryanarayana, K.,, K. Baczko,, V. ter Meulen,, and R. R. Wagner. 1994- Transcription inhibition and other properties of matrix proteins expressed by M genes cloned from measles viruses and diseased human brain tissue. J. Virol. 68:15321543.
116. Tauro, S.,, V. Toh,, H. Osman,, and P. Mahendra. 2000. Varicella zoster meningoencephalitis following treatment for dermatomal zoster in an alio BMT patient. Bone Marrow Transplant. 26:795796.
117. Thomas, C.,, G. DeSaint Basile,, E. LeDeist,, D. Theophile,, M. Benkerrou,, E. Haddad,, S. Blanche,, and A. Fischer. 1995. Brief Report: correction of x-linked hyper IgM syndrome by allogenic bone marrow transplantation. N. Engl. J . Med. 333:426429.
118. Tornatore, C.,, J. R. Berger,, S. A. Houff,, B. Curfman,, K. Meyers,, D. Winfield,, and E. O. Major. 1992. Detection of JC virus DNA in peripheral lymphocytes from patients with and without progressive multifocal leukoencephalopathy. Ann. Neurol. 31:454462.
119. Weaver, S.,, M. K. Rosenblum,, and L. M. DeAngelis. 1999. Herpes varicella zoster encephalitis in immunocompromised patients. Neurology 52:193195.
120. Wilfert, C. M.,, R. H. Buckley,, T. Mohanakumar,, J. E Griffith,, S. L . Katz,, J . K. Whisnant,, P. A. Egglesto,, M. Moore,, E. Treadwell,, M. N. Oxman,, and F. S. Rosen. 1977. Persistent and fatal central nervous system echovirus infections in patients with agammaglobulinemia. N. Engl. J. Med. 296: 14851489.
121. Willoughby, E.,, R. W. Price,, B . L. Padgett,, D. L. Walker,, and B. Dupont. 1980. Progressive multifocal leukoencephalopathy (PML): in vitro cell-mediated immune responses to mitogens and JC virus. Neurology 30:256262.
122. Wolinsky, J . S.,, P. Swoveland,, K. P. Johnson,, and K. P. Baringer. 1977. Subacute measles encephalitis complicating Hodgkin's disease in an adult. Ann. Neurol. 1:452457.
123. Wyatt, H. V. 1973. Poliomyelitis in hypogammaglobulinemics. J. Infect. Dis. 128:802806.
124. Yiannoutsos, C. T.,, E. O. Major,, B . Curfman,, P. N . Jensen,, M. Gravell,, J . Hou,, D. B. Clifford,, and C. D. Hall. 1999. Relation of JC virus DNA in the cerebrospinal fluid to survival in acquired immunodeficiency syndrome patients with biopsyproven progressive multifocal leukoencephalopathy. Ann. Neurol. 45:816821.
125. Zelman, I. B.,, and M. J. Mossakowski. 1998. Opportunistic infections of the central nervous system in the course of acquired immune deficiency syndrome (AIDS). Morphological analysis of 172 cases. Folia Neuropathol. 36:129144.
126. Zu Rhein, G. M.,, and S.-M. Chou. 1965. Particles resembling papovaviruses in human cerebral demyelinating disease. Science 148:14771479.

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