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Arch Neurol. Human Metapneumovirus in the Cerebrospinal Fluid of a Patient With Acute Encephalitis

Giuseppe

Emeritus
[Source: Archives of Neurology, full text: (LINK). Abstract, edited.]


Human Metapneumovirus in the Cerebrospinal Fluid of a Patient With Acute Encephalitis


Iv?n S?nchez Fern?ndez, MD; M?nica Rebollo Polo, MD; Carmen Mu?oz-Almagro, MD; Laura Monfort Carretero, MD; Sergio Fern?ndez Ure?a, MD; Adela Rueda Mu?oz, MD; Roser Colom? Roura, MD; Bel?n P?rez Due?as, MD, PhD


Arch Neurol. Published online January 9, 2012. doi:10.1001/archneurol.2011.1094


Objective To report, to our knowledge, the first case of detection of human metapneumovirus in the cerebrospinal fluid of a patient during acute encephalitis.


Design Case report.


Setting University hospital.


Patient A 10-year-old girl with acute encephalitis.


Results Human metapneumovirus was detected in cerebrospinal fluid and nasal-wash specimens during the initial phase of mild encephalitis. Abrupt clinical deterioration was associated with the presence of multiple areas of demyelination and cortical abnormalities. Demyelinated areas improved after immunomodulatory therapy, but cortical lesions spread in both hemispheres. Surprisingly, clinical worsening occurred when the virus became undetectable in cerebrospinal fluid.


Conclusions The detection of human metapneumovirus in cerebrospinal fluid strongly suggests its causative role in acute encephalitis. The evolution of the clinical and radiological features provided insight into the pathogenesis of human metapneumovirus encephalitis.

Author Affiliations: Departments of Child Neurology (Drs S?nchez Fern?ndez, Colom? Roura, and P?rez Due?as), Radiology (Dr Rebollo Polo), and Clinical Laboratory (Dr Mu?oz-Almagro), and the Intensive Care Unit (Drs Monfort Carretero and Fern?ndez Ure?a), Area B?sica Salud Pou Torres (Dr Rueda Mu?oz), Hospital Sant Joan de D?u, Barcelona, Spain.
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Re: Arch Neurol. Human Metapneumovirus in the Cerebrospinal Fluid of a Patient With Acute Encephalitis

Surprisingly, clinical worsening occurred when the virus became undetectable in cerebrospinal fluid.

I wonder if an autoimmune response started at some point?

Here's an article from 2007 reporting suspicion of HMPV causing neurological illness:
http://www.nih.go.jp/JJID/60/328.pdf
 
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