Persistent Coxsackie B encephalitis: Report of a case and review of the literature

Although the diagnosis is rarely confirmed, enteroviruses are a common cause of meningitis. Coxsackie B is responsible for more than half of the cases of aseptic meningitis in infants less than 3 months old, but is less common as a cause of neurological disease in older persons. In addition to asept...

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Bibliographic Details
Published in:Journal of neurovirology 2006-12, Vol.12 (6), p.511-516
Main Authors: Berger, Joseph R, Chumley, Warren, Pittman, Thomas, Given, Curtis, Nuovo, Gerard
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biopsy
Brain - pathology
Brain - virology
Coxsackievirus
Diagnosis, Differential
Encephalitis, Viral - diagnosis
Enterovirus
Enterovirus B, Human
Enterovirus Infections - complications
Enterovirus Infections - pathology
Enterovirus Infections - physiopathology
Female
Human viral diseases
Humans
Immunohistochemistry
Infectious diseases
Magnetic Resonance Imaging
Medical sciences
Neurodegenerative Diseases
Neurology
Reverse Transcriptase Polymerase Chain Reaction
Seizures - etiology
Tomography, X-Ray Computed
Tumors of the nervous system. Phacomatoses
Vascular diseases and vascular malformations of the nervous system
Viral diseases
Viral diseases of the nervous system
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Summary:Although the diagnosis is rarely confirmed, enteroviruses are a common cause of meningitis. Coxsackie B is responsible for more than half of the cases of aseptic meningitis in infants less than 3 months old, but is less common as a cause of neurological disease in older persons. In addition to aseptic meningitis, Coxsackie B has been reported to cause a wide range of other neurological disorders, albeit rarely. The authors report a young adult with persistent Coxsackie B encephalitis that was heralded by focal seizures and evolved to intractable coma with multifocal myoclonus. The diagnosis was established by immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) on tissue obtained at brain biopsy. Cerebrospinal fluid (CSF) viral cultures and PCR were negative for enteroviruses. This case highlights unusual features of a persistent infection that could easily have been mistaken for a neurodegenerative or other noninfectious process. It also emphasizes the importance of performing brain biopsy on individuals with neurological disease of obscure nature.
ISSN:1355-0284
1538-2443
DOI:10.1080/13550280601090546