Maternal herpetic breast infection: another hazard of neonatal herpes simplex.

After the death of an eight-day-old breast-fed neonate with disseminated herpes simplex, the mother was found to have herpes simplex infections of both nipples. This complication of neonatal herpes infection does not appear to have been reported previously.     

Neonatal herpes simplex virus infection occurring in second twin of an asymptomatic mother. Failure of a modern protocol

A case of neonatal herpes that occurred after vaginal delivery in the absence of genital lesions is presented. The mother had a history of drug addiction and genital herpes. Asymptomatic shedding of herpes simplex virus type 2 from the cervix was noted in the second trimester of pregnancy. Despite being followed with a protocol of close surveillance and serial culturing of the genital tract, the patient gave birth to twins, one of whom developed herpes simplex virus type 2 in the postpartum period. This report presents discussion of this case and herpes surveillance protocols.     

单纯疱疹病毒感染诊断方法及标本选择的探讨

目的目的探讨单纯疱疹病毒（HSV）感染诊断方法及标本的选择对诊断结果的意义。方法选择117例疑似HSV感染的皮肤科门诊患者或神经内科脑炎脑膜炎患者血清，其中53例有明显疱疹症状者同时取疱液标本，78例脑炎脑膜炎患者同时采集脑脊液标本。应用ELISA法、免疫印迹法检测血清、脑脊液中HSV—IgM抗体，应用间接免疫荧光法（IIF）检测脑脊液、疱疹液HSV抗原。结果血清、脑脊液标本ELISA法和免疫印迹法检测HSV—IgM抗体阳性率分别为70．94％、6．41％和59．83％、3．85％。脑脊液、疱疹液TIF法检测HSV抗原阳性率分别是15．38％、67．93％。结论ELISA法与免疫印迹法检测HSV—IgM抗体阳性率无显著性差异（γ=0．017，P〉0．5）；脑脊液标本供检测HSV抗原与HSVIgM抗体的阳性率差异显著（γ=13．224，P〈0．05．）；对复发感染患者采用疱疹液抗原检测相对于采用血清检测抗体对诊断HSV感染更具有临床意义。在临床上，对不同病症病程的HSV感染，选择相应适宜的诊断方法及标本种类可取得更准确的检测结果。     

A fatal case of Epstein-Barr virus infection with jaundice and renal failure.

A fatal case of Epstein-Barr virus infection in a 17-year-old male is described. The patient presented with an illness clinically typical of infectious mononucleosis but death followed development of renal failure, jaundice and pulmonary failure. There was no absolute lymphocytosis nor a significant number of atypical mononuclear cells in his peripheral blood. However, heterophile antibody and Epstein-Barr virus-specific IgM were present.     

A fatal case of chikungunya virus infection with liver involvement

Recovery from chikungunya is previously considered universal and mortality due to the virus is rare and unusual. Findings from recent chikungunya outbreaks occurred in Reunion Island and India have since challenged the conventional view on the benign nature of the illness. Malaysia has experienced at least of 4 outbreaks of chikungunya since 1998. In the present on-going large outbreak due to chikungunya virus of Central/East African genotype, a previous healthy sixty six years gentleman without co-morbidity was noted to have severe systemic infection by the virus and involvement of his liver. He subsequently passed away due to cardiovascular collapse after 5 days of illness.     

Disseminated herpesvirus infection. Association with primary genital herpes in pregnancy.

A patient with primary herpes simplex virus (HSV) type 2 genital infection had dissemination in the 37th week of her first pregnancy. This was manifested by severe hepatitis, pancreatitis, and genital lesions. Temporary improvement followed the delivery of a healthy infant by cesarean section. Encephalitis became evident on the third postpartum day, and recovery was complicated by profound bradycardia, possibly due to viral myocarditis. Vidarabine was administered for seven days, and the patient survived with only mild neurologic sequellae. To our knowledge, this the fourth reported case of disseminated herpesvirus infection in pregnancy and the first due to HSV type 2. Pregnancy must be considered as a possible predisposing factor in dissemination of primary HSV infection.     

Profiles of herpes simplex virus type 1 antibodies in primary herpetic infections of the maxillofacial regions

Changes in the aspects of primary infection of herpes simplex virus type 1 in the maxillofacial region have been observed due to the increase in the number of adult cases. To elucidate the possibility of serologic diagnosis in primary infectious patients and the influence of virucide on antibody production, we evaluated changes in serum antibodies (neutralizing antibody, IgM, and IgG antibody) in pair serum in 35 primary infectious patients using a micro-plate method and ELISA. At the first examination, 31 (89%) of 35 patients did not have neutralizing antibodies, and 23 of the 31 patients showed significant increases of neutralizing antibody titer more than four times at the second examination. Three of the 4 patients that had neutralizing antibodies showed significant increases at the second examination; therefore, 26 (74.3%) of the 35 patients could be diagnosed as having primary infection only by neutralizing antibodies. Regarding 9 patients who did not show significant increases in neutralizing antibodies, 5 of the 9 patients showed increases in IgG antibody titer more than two times at the second examination, and at the first examination, IgM antibody titer in 3 of the remaining 4 patients was more than 0.2 that is the cut-off value; therefore, it was possible to diagnose the 8 patients as having primary infection. We evaluated the influence of the use of virucide, gender, age, period between onset and the first examination, and period between onset and the second blood collection on antibody production; however, there were no differences observed except that significant increases in antibody were observed in 4 children aged below 10 years, although they used virucide. These results revealed that it was not possible to serologically diagnose whether there was primary or recurrent infection only by neutralizing antibody titer.     

生殖器疱疹患者血清IgM抗体和皮损抗原检测的意义

目的 :评价生殖器疱疹 (GH)患者血清单纯疱疹病毒 (HSV)IgM抗体和皮损HSV抗原检测的临床意义。方法 :用酶联免疫吸附实验 (ELISA)方法对 5 2例GH患者在皮损发作期同时检测血清IgM抗体和局部皮损中HSV抗原。结果 :5 2例患者血清HSVIgM抗体阳性 7例 ,阳性率为 13.4 6 % (7/ 5 2 ) ,IgM阳性组疱疹复发平均间隔时间与IgM阴性组比较 ,无显著性差异 (P >0 .0 5 )。皮损HSV抗原阳性 31例 ,阳性率 5 9.6 2 % (31/ 5 2 ) ,其中丘疹、丘疱疹、水疱性损害阳性率 10 0 % (13/ 13) ,糜烂或浅表溃疡性损害阳性率 6 3.6 4 % (14 / 2 2 ) ,结痂性损害阳性率 2 3.5 3% (4 / 17)。皮损HSV抗原检测阳性率显著高于血清HSVIgM抗体阳性率 (P <0 .0 5 )。结论 :血清HSVIgM抗体检测对GH诊断和判断复发价值不大 ,皮损HSV抗原检测对诊断GH活动性感染具有更重要的临床意义。