Background: Neonates with blistering skin diseases are dermatologic emergencies. The pathologies involved can pose diagnostic difficulties and there exists a variety of potential life-threatening differential diagnoses.
Objective: description of the first case of intrauterine acquired herpes simplex virus (HSV) 1 infection in twins.
Methods: We present the case of two premature bicordial biamniotic twins (27th week of gestation) whose intrauterine growth retardation, fetal anaemia and cardiotocography abnormalities led to a caesarean emergency delivery.
Results: Accurate medical history revealed a maternal febrile gingivostomatitis at the 23rd week of gestation, which was neglected by the treating gynaecologist. Respiratory distress was present at delivery and intubation was necessary in both children. The whole skin showed extensive erosions and ulcerations and the mucosa of the eyes and genitals was also involved. Intrauterine Herpes simplex virus (HSV) 1 infection was confirmed by immunohistochemistry of skin Tzanck smear (HSV 1 positive, HSV 2 negative), real-time polymerase chain reaction of both serum and skin (HSV 1 positive; HSV 2 negative) and maternal serology positive for HSV 1 IgM and IgG. Siblings were immediately treated with high-dose endovenous acyclovir. Anaemia thrombocytopenia and hepatorenal values markedly deteriorated and both developed consequential hepatorenal failure. The third day live supportive measures were terminated after parental informed consent and both siblings deceased shortly after on their mother's breast.
Discussion: Intrauterine HSV infection is rare and accounts only for 5% of neonatal HSV infections. Literature reports only 64 cases and 90% of those are related to HSV-2. Transplacental viral transmission is highest during the first 20 weeks of gestation and has been observed in pregnant women with disseminated HSV infection. Mortality and morbidity of intrauterine herpetic infection are extremely high.
Conclusion: Despite transplacental HSV transmission remains a rare event, the potential devastating outcome justifies immediate adequate antiviral treatment in a pregnant woman affected by primary HSV infection.
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http://dx.doi.org/10.1111/jdv.12583 | DOI Listing |
Alzheimers Dement
December 2024
MRC Unit for Lifelong Health & Ageing at UCL, London, United Kingdom.
Background: Associations of common infections with Alzheimer's disease have been reported, but potential mechanisms underlying these relationships are unclear. A hypothesised mechanism is amyloid-beta (Aβ) aggregation as a defense mechanism in response to infection, with subsequent tau accumulation. However, no studies have assessed associations of infections with cerebral Aβ and tau pathology in vivo.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Colorado School of Medicine, Aurora, CO, USA.
Background: Varicella zoster virus (VZV) reactivation, manifesting as herpes zoster, increases dementia risk. Herein, we review the literature supporting the biological plausibility of VZV contributing to AD pathologies and examine the unique ability of VZV to induce amylin that has been found in blood vessels and parenchyma of AD patients.
Method: We conducted a literature review on VZV and dementia to elucidate a potential model for how VZV reactivation intersects with AD.
Background: Hallmark features of AD are well defined, however, the generation of in vitro models of sporadic AD poses a significant challenge due to the complex, undefined etiology and slow progression of this disease. Herpes simplex virus type I (HSV-1) is a pathogen that is gaining increasing attention as a potential causative agent in AD pathogenesis. HSV-1 is a DNA virus that typically resides throughout the peripheral nervous system in a latent state.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Texas Medical Branch, Galveston, TX, USA.
Background: Chronically reactivating Herpes Simplex Virus Type 1 (HSV1) infection has been shown to produce key molecular and behavioral markers of Alzheimer's disease (AD). Most notably, the accumulation of neurotoxic tau isoforms, neurofibrillary tangles (NFTs), and Amyloid-beta plaques. Our study takes a unique approach to the systematic characterization of HSV1 biomarkers within the brain.
View Article and Find Full Text PDFCase Rep Obstet Gynecol
December 2024
Department of Obstetrics and Gynecology, Jimma University School of Medicine, Jimma, Ethiopia.
Fetal limb anomaly presentation varies greatly. It can present as amelia (complete absence of skeletal part of one or more limb), meromelia (partial absence of skeletal part of one or more limb), phocomelia (only rudimentary limb formed), and minor limb disorders like polydactyly. The complete absence of the four fetal limbs is extremely rare.
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