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Central nervous system infections in a tropical area: influence of emerging and rare infections.
Eur J Neurol. 2020 Jun 30 [Online ahead of print]EJ

Abstract

BACKGROUND AND PURPOSE

The frequency of infectious encephalitis and the distribution of causative pathogens in tropical areas are poorly known and may be influenced by emerging and rare infections. The aim was to characterize a large series of acute infectious encephalitis and myelitis in immunocompetent patients from the Caribbean island of Guadeloupe identifying clinical, biological and radiological features according to pathogens.

METHODS

Using a hospital database, detailed information on a comprehensive series of immunocompetent patients with acute infectious myelitis and encephalitis over the 2012-2018 period was retrospectively collected.

RESULTS

From 259 suspected cases with acute central nervous system infection, 171 cases were included for analysis, comprising 141 encephalitis, 22 myelitis and eight encephalomyelitis. The annual incidence peaked at 15.0/100 000 during the Zika 2016 outbreak. Children accounted for 22.2% of cases. Eight adults died during hospital stay, all encephalitis. Seventeen infectious agents, two of which had never been described in Guadeloupe so far, were identified in 101 cases (59.1%), including 35 confirmed cases (34.7%), 48 probable cases (47.5%), 15 possible cases (14.9%) and three clinical cases (3.0%). The most frequent etiologic agents were Zika virus in 23 cases (13.5%), herpes simplex in 12 (7.0%), varicella zoster virus in 11 (6.4%), dengue virus in 11 (6.4%) and leptospirosis in 11 (6.4%).

CONCLUSIONS

The Zika outbreak had a major influence on the annual incidence of acute central nervous system infection. Acute neuroleptospirosis is over-represented in our series. Further efforts are mandatory to develop new diagnostic tools for pathogen profiling.

Authors+Show Affiliations

Service de Neurologie, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre/Abymes, France. Faculté de Médecine de l'Université des Antilles, Pointe-à-Pitre, France. Faculté de Médecine de Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, U 1127, CNRS, Unité Mixte de Recherche (UMR) 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.Faculté de Médecine de Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, U 1127, CNRS, Unité Mixte de Recherche (UMR) 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France. Département de Neurologie, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France.Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, France.Perception and Memory Unit, Unité Mixte de Recherche 3571, Institut Pasteur, Centre National de la Recherche Scientifique, Paris, France.Service de Neurologie, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre/Abymes, France. Faculté de Médecine de l'Université des Antilles, Pointe-à-Pitre, France. Faculté de Médecine de Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, U 1127, CNRS, Unité Mixte de Recherche (UMR) 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France. Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32602577

Citation

Chaumont, H, et al. "Central Nervous System Infections in a Tropical Area: Influence of Emerging and Rare Infections." European Journal of Neurology, 2020.
Chaumont H, Roze E, Tressières B, et al. Central nervous system infections in a tropical area: influence of emerging and rare infections. Eur J Neurol. 2020.
Chaumont, H., Roze, E., Tressières, B., Lazarini, F., & Lannuzel, A. (2020). Central nervous system infections in a tropical area: influence of emerging and rare infections. European Journal of Neurology. https://doi.org/10.1111/ene.14422
Chaumont H, et al. Central Nervous System Infections in a Tropical Area: Influence of Emerging and Rare Infections. Eur J Neurol. 2020 Jun 30; PubMed PMID: 32602577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Central nervous system infections in a tropical area: influence of emerging and rare infections. AU - Chaumont,H, AU - Roze,E, AU - Tressières,B, AU - Lazarini,F, AU - Lannuzel,A, Y1 - 2020/06/30/ PY - 2020/04/11/received PY - 2020/06/21/revised PY - 2020/06/25/accepted PY - 2020/7/1/pubmed PY - 2020/7/1/medline PY - 2020/7/1/entrez KW - Guadeloupe KW - Zika KW - encephalitis KW - leptospirosis KW - transverse myelitis JF - European journal of neurology JO - Eur. J. Neurol. N2 - BACKGROUND AND PURPOSE: The frequency of infectious encephalitis and the distribution of causative pathogens in tropical areas are poorly known and may be influenced by emerging and rare infections. The aim was to characterize a large series of acute infectious encephalitis and myelitis in immunocompetent patients from the Caribbean island of Guadeloupe identifying clinical, biological and radiological features according to pathogens. METHODS: Using a hospital database, detailed information on a comprehensive series of immunocompetent patients with acute infectious myelitis and encephalitis over the 2012-2018 period was retrospectively collected. RESULTS: From 259 suspected cases with acute central nervous system infection, 171 cases were included for analysis, comprising 141 encephalitis, 22 myelitis and eight encephalomyelitis. The annual incidence peaked at 15.0/100 000 during the Zika 2016 outbreak. Children accounted for 22.2% of cases. Eight adults died during hospital stay, all encephalitis. Seventeen infectious agents, two of which had never been described in Guadeloupe so far, were identified in 101 cases (59.1%), including 35 confirmed cases (34.7%), 48 probable cases (47.5%), 15 possible cases (14.9%) and three clinical cases (3.0%). The most frequent etiologic agents were Zika virus in 23 cases (13.5%), herpes simplex in 12 (7.0%), varicella zoster virus in 11 (6.4%), dengue virus in 11 (6.4%) and leptospirosis in 11 (6.4%). CONCLUSIONS: The Zika outbreak had a major influence on the annual incidence of acute central nervous system infection. Acute neuroleptospirosis is over-represented in our series. Further efforts are mandatory to develop new diagnostic tools for pathogen profiling. SN - 1468-1331 UR - https://www.unboundmedicine.com/medline/citation/32602577/Central_nervous_system_infections_in_a_tropical_area:_Influence_of_emerging_and_rare_infections L2 - https://doi.org/10.1111/ene.14422 DB - PRIME DP - Unbound Medicine ER -
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