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Herpes simplex encephalitis – diagnostic imaging

100%

Tyrakowska-Dadełło Z., Kułakowska A., Zajkowska J., Pancewicz S., Tarasów E.

Progress in Health Sciences

2017

vol. 7(1)

152-160

The phenomena of neuroinvasiveness, latency and reactivation are characteristics of the Herpes simplex virus (HSV). The Herpes simplex encephalitis (HSE) prevalence rate is 1 up to 3 in a million cases, which is about 10-20% of all viral encephalitis cases. The course of the disease shows the prodromal period and the symptomatic one; the clinical course is usually rapid and may lead to sudden death. As for the symptomatic period, there are usually neurological focal symptoms and seizures as well as fluctuating consciousness leading to coma. The mortality rate in the course of HSE in non-treated individuals reaches up to 70%, it is lowered to 15% with early treatment with Acyclovir. However, most patients present persistent neurological and cognitive disorders. There are usually no changes in the CT scan as far as the early stage of the disease is concerned. Thus, the imaging technique of choice is MR scan, which shows the changes already on the second day after clinical symptoms. On the basis of MR scans, more or less symmetrical hyperintense cortical and subcortical white matter lesions occur on T2-weighted images with gyral and/or leptomeningeal contrast enhancement. MR spectroscopy can be helpful in lesion diagnosis and monitoring, while diffusion-weighted imaging (DWI) can be used to evaluate inflammatory process activity. Differentiation of HSE in imaging should consider limbic encephalitis, gliomatosis cerebri, cerebral ischemia, cerebral edema after seizure episodes, and MELAS syndrome (Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes), among others. HSV identification in cerebrospinal fluid by PCR (polymerase chain reaction) method is a confirmation of the diagnosis.

Lyme disease: etiology, pathogenesis, clinical courses, diagnostics and treatment

72%

Wasiluk A., Zalewska-Szajda B., Waszkiewicz N., Kępka A., Szajda D., Wojewódzka-Żeleźniakowicz M., Ładny J., Pancewicz S., Zwierz Z., Zwierz K.

Progress in Health Sciences

2011

vol. 1

issue 2

179-186

Lyme disease (LD) is caused by Borrelia burgdorferi, transferred by infected ticks Ixodus ricinus. LD occurs endemically in Europe, America and Northern regions of Asia. In Poland, LD is the most frequent tick borne disease, which causes serious epidemiological problems. The main health hazard of LD occurs on the forested areas of Podlasie, Maritime province, the West Poland lake district, and Carpathians. The highest incidence 114.0 per 100 000 was registered in Podlaskie province. The infectious cycle of Borrelia burgdorferi includes: nymph moulds to adult, eggs laid by female, eggs hatch to larva, larva feeds on first host, fully fed larva drops to ground, larva moulds to nymph, nymph attaches to and feeds on the second host. LD is a chronic disease attacking many organs, including the skin, heart, brain and joints. LD is divided into three stages based on clinical symptoms: I - limited infection (Erythema migrans and Borrelia lymphoma), II - disseminated infection (numerous erythema migrans, early neuro-borreliosis, joint inflammation, Lyme carditis), III - late borreliosis (chronic atrophic limbs infla-mmation, late neuroborreliosis, chronic joint infla-mmation). At present, the best diagnostic method for LD is a labor- and time consuming two-stage serological method. First-line antibiotics in the treatment of Lyme disease are doxycycline, amoxicillin, cefuroxime axetil, ceftriaxone, cefo-taxime, and penicillin G. The best method of avoiding Borrelia burgdorferi infection is to avoid biting from ticks carrying spirochetes. Early removal of ticks, protects against spirochaetal infection.

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2 Progress in Health Sciences

2 Pancewicz S.

1 Kułakowska A.

1 Kępka A.

1 Szajda D.

1 Tarasów E.

1 Tyrakowska-Dadełło Z.

1 Wasiluk A.

1 Waszkiewicz N.

1 Wojewódzka-Żeleźniakowicz M.

1 Zajkowska J.

1 Zalewska-Szajda B.

1 Zwierz K.

1 Zwierz Z.

1 Ładny J.

1 2017

1 2011

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Herpes simplex encephalitis – diagnostic imaging

Lyme disease: etiology, pathogenesis, clinical courses, diagnostics and treatment