Difference between revisions of "IPLab:Lab 8:HSV Encephalitis"

From Pathology Education Instructional Resource
Jump to: navigation, search
(Images)
 
(3 intermediate revisions by the same user not shown)
Line 1: Line 1:
 
== Clinical Summary ==
 
== Clinical Summary ==
  
This 30-year-old white male experienced a generalized tonic-clonic seizure and was subsequently started on a course of Dilantin. He did well, but later developed a headache lasting over a week, which was associated with tonic-clonic seizures, fever, and--toward the end of this period--ataxia. The patient improved and returned to work, but the headache returned. A lumbar puncture was then performed which showed 22 cells/cmm (all lymphocytes), protein of 88 grams/L, and a glucose level of 49 mg/dL (with a simultaneous serum glucose of 83 mg/dL). These findings were compatible with a viral infection. Despite therapy, the patient had another seizure and again developed fever. At that time, a brain biopsy was performed which showed herpetic encephalitis. Despite aggressive antiviral therapy the patient died.  
+
This 30-year-old white male experienced a generalized tonic-clonic seizure and was subsequently started on a course of Dilantin. He did well, but later developed a headache lasting over a week, which was associated with tonic-clonic seizures, fever, and--toward the end of this period--ataxia. The patient improved and returned to work, but the headache returned. A lumbar puncture was then performed which showed 22 cells/mm³ (all lymphocytes), protein of 88 grams/L, and a glucose level of 49 mg/dL (with a simultaneous serum glucose of 83 mg/dL). These findings were compatible with a viral infection. Despite therapy, the patient had another seizure and again developed fever. At that time, a brain biopsy was performed which showed herpetic encephalitis. Despite aggressive antiviral therapy the patient died.
  
 
== Images ==
 
== Images ==
Line 18: Line 18:
 
IPLab8HSVEncephalitis12.jpg|This is a photomicrograph of a brain section stained with an antibody against herpes simplex. Even at this magnification, it is easy to pick out cells that are positive for the virus (arrows).  
 
IPLab8HSVEncephalitis12.jpg|This is a photomicrograph of a brain section stained with an antibody against herpes simplex. Even at this magnification, it is easy to pick out cells that are positive for the virus (arrows).  
 
</gallery>
 
</gallery>
 +
 +
== Virtual Microscopy ==
 +
<peir-vm>IPLab8HSVEncephalitis</peir-vm>
  
 
== Study Questions ==
 
== Study Questions ==
Line 36: Line 39:
  
 
=== Images ===
 
=== Images ===
* [http://peir.path.uab.edu/library/index.php?/tags/127-herpes PEIR Digital Library: Herpes Images]
+
* [{{SERVER}}/library/index.php?/tags/127-herpes PEIR Digital Library: Herpes Images]
 
* [http://library.med.utah.edu/WebPath/CNSHTML/CNSIDX.html#6 WebPath: CNS Infections]
 
* [http://library.med.utah.edu/WebPath/CNSHTML/CNSIDX.html#6 WebPath: CNS Infections]
  
 
== Related IPLab Cases ==
 
== Related IPLab Cases ==
 
+
* [[IPLab:Lab 8:HSV Glossitis|Lab 8: Herpes Glossitis]]
  
 
{{IPLab 8}}
 
{{IPLab 8}}
  
 
[[Category: IPLab:Lab 8]]
 
[[Category: IPLab:Lab 8]]

Latest revision as of 16:28, 3 January 2014

Clinical Summary[edit]

This 30-year-old white male experienced a generalized tonic-clonic seizure and was subsequently started on a course of Dilantin. He did well, but later developed a headache lasting over a week, which was associated with tonic-clonic seizures, fever, and--toward the end of this period--ataxia. The patient improved and returned to work, but the headache returned. A lumbar puncture was then performed which showed 22 cells/mm³ (all lymphocytes), protein of 88 grams/L, and a glucose level of 49 mg/dL (with a simultaneous serum glucose of 83 mg/dL). These findings were compatible with a viral infection. Despite therapy, the patient had another seizure and again developed fever. At that time, a brain biopsy was performed which showed herpetic encephalitis. Despite aggressive antiviral therapy the patient died.

Images[edit]

Virtual Microscopy[edit]

Study Questions[edit]


Additional Resources[edit]

Reference[edit]

Journal Articles[edit]

Images[edit]

Related IPLab Cases[edit]

A tonic-clonic seizure involves loss of consciousness followed by tonic, then clonic, convulsions.

A tonic-clonic seizure involves loss of consciousness followed by tonic, then clonic, convulsions.

A normal number of cells in CSF is <4 lymphocytes per mm³.

A normal protein level for CSF should be < 0.4 grams/L.

A normal CSF glucose level should be approximately 70% of the patient's serum glucose level.

An infiltrate is an accumulation of cells in the lung parenchyma--this is a sign of pneumonia.