Macacine alphaherpesvirus 1: Difference between revisions
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== Diagnosis == |
== Diagnosis == |
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| + | * Serology, with acute and convalescent (3 to 6 weeks) titres, looking for a 4-fold rise |
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| + | ** Seroconversion may be delayed if on acyclovir, so should be repeated at 12 weeks |
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| + | ** Done at NML or sent out to Georgia State University |
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| + | * Viral culture is possible but not done routinely |
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| + | * PCR is available for swab, tissue, blood, and CSF |
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| + | ** Sent out to Georgia State University |
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| + | ** In autopsy, send right and left trigeminal ganglia or the sacral dorsal root ganglia |
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== Management == |
== Management == |
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Revision as of 09:15, 15 October 2019
Background
- Also known as macacine herpesvirus 1, macacine alphaherpesvirus 1, cercopithecine herpesvirus 1, CHV-1), herpes B virus, monkey B virus, herpesvirus simiae and herpesvirus B
History
- First diagnosed in a researcher in 1933
Microbiology
- Double-stranded DNA virus
- Alphaherpesvirus, in the same family as HSV
Pathophysiology
- Virus replicates locally at the site of inoculation, then spreads from peripheral nerves to spinal cord to brainstem to brain
Clinical Presentation
- Typically via bite or scratch of macaque monkey
- Asymptomatic or similar presentation to HSV in the monkey
- Seroprevalence reaches 100% in some populations of macaques
- Incubation period 5 to 21 days (range 2 days to 5 weeks)
- Three clinical forms:
- Flu-like illness followed by CNS symptoms
- Local symptoms (itching, tingling, numbness, or pain) at the inoculation site, with or without vesicular rash and regional lymphadenopathy
- Peripheral or central nervous system symptoms, with meningismus, vomiting, confusion, cranial nerve palsies
- Eventually progresses to global encephalitis, seizures, paralysis, and respiratory failure
- Mortality 70% if untreated
Diagnosis
- Serology, with acute and convalescent (3 to 6 weeks) titres, looking for a 4-fold rise
- Seroconversion may be delayed if on acyclovir, so should be repeated at 12 weeks
- Done at NML or sent out to Georgia State University
- Viral culture is possible but not done routinely
- PCR is available for swab, tissue, blood, and CSF
- Sent out to Georgia State University
- In autopsy, send right and left trigeminal ganglia or the sacral dorsal root ganglia
Management
References
- ^ F. P. Gay, M. Holden. Isolation of a Herpes Virus from Several Cases of Epidemic Encephalitis.. Experimental Biology and Medicine. 1933;30(8):1051-1053. doi:10.3181/00379727-30-6788.
- ^ Joshua Fierer. Herpes B Virus Encephalomyelitis Presenting as Ophthalmic Zoster. Annals of Internal Medicine. 1973;79(2):225. doi:10.7326/0003-4819-79-2-225.
