Encefalite neo-natal pelo vírus do Herpes simplex: diagnóstico imuno-histoquímico de um caso

Lamego, Isabel; Brinckmann, Carlos; Ciancio, Aldo; Minotto, Renan; Hilbig, Arlete; Ulbrich-Kulczynski, Jane Maria; Fontana, Maria Helena; Barbosa-Coutinho, Lígia Maria

doi:10.1590/S0004-282X1993000300015

Resumos

Os autores relatam o caso de recém-nascido do sexo feminino com crises convulsivas e lesões vesiculosas no nariz e lábio inferior, desde o quinto dia de vida. O exame do LCR mostrou alterações compatíveis a encefalite. Houve deterioração do quadro neurológico e respiratório, com morte da paciente. A autópsia parcial do crânio revelou cérebro edemaciado com área necro-hemorrágica envolvendo ambos os lobos temporais. O exame histopatológico revelou encefalite necro-hemorrágica, sem a presença de inclusões intranucleares. O exame imuno-histoquímico, realizado pela técnica da avidina-biotina-peroxidase utilizando anticorpos policlonais contra vírus Herpes simplex tipo 1 e tipo 2, mostrou-se positivo em numerosas células neuronais, astrocíticas e, principalmente, oligodendrogliais para o anticorpo contra o vírus Herpes simplex tipo 2.

encefalite; Herpes simplex vírus; imuno-histoquímica

The authors report the case of a female newborn infant, who had seizures and vesicles at the nose and inferior lip since the fifth day of life. CSF changes suggested an encephalitis. Signs of neurologic and respiratory deterioration were followed by death. Partial cranial autopsy showed a necrohemorrhagic temporal encephalitis without intranuclear inclusions. Immunohistochemical examination by the avidin-biotin-peroxidase technique with polyclonal antibodies against Herpes simplex type 1 and type 2 was positive to type 2 Herpes simplex virus.

encephalitis; Herpes simplex virus; immunohistochemistry

Encefalite neo-natal pelo vírus do Herpes simplex: diagnóstico imuno-histoquímico de um caso

Neonatal encephalitis by Herpes simplex: immunohistochemical diagnosis of a case

Isabel Lamego^I; Carlos Brinckmann^I; Aldo Ciancio^II; Renan Minotto^II; Arlete Hilbig^III; Jane Maria Ulbrich-Kulczynski^IV; Maria Helena Fontana^V; Lígia Maria Barbosa-Coutinho^VI

^IBolsista de Iniciação Científica do CNPq (Processo 806094/89-3)

^IIBolsista da FAFERGS (Processo 90.1970.0)

^IIIMestranda do Curso de Pós-Graduação em Medicina (Clínica Médica) da Universidade Federal do Rio Grande do Sul (UFRGS)

^IVPatologista do Hospital da Criança Santo Antonio (HCSA)

^VNeuropediatra do HCSA

^VIProfessora Titular de Anatomia Patológica da FFFCMPA, Neuropatologista, Pesquisadora do CNPq

RESUMO

Os autores relatam o caso de recém-nascido do sexo feminino com crises convulsivas e lesões vesiculosas no nariz e lábio inferior, desde o quinto dia de vida. O exame do LCR mostrou alterações compatíveis a encefalite. Houve deterioração do quadro neurológico e respiratório, com morte da paciente. A autópsia parcial do crânio revelou cérebro edemaciado com área necro-hemorrágica envolvendo ambos os lobos temporais. O exame histopatológico revelou encefalite necro-hemorrágica, sem a presença de inclusões intranucleares. O exame imuno-histoquímico, realizado pela técnica da avidina-biotina-peroxidase utilizando anticorpos policlonais contra vírus Herpes simplex tipo 1 e tipo 2, mostrou-se positivo em numerosas células neuronais, astrocíticas e, principalmente, oligodendrogliais para o anticorpo contra o vírus Herpes simplex tipo 2.

Palavras-chave: encefalite, Herpes simplex vírus, imuno-histoquímica.

SUMMARY

The authors report the case of a female newborn infant, who had seizures and vesicles at the nose and inferior lip since the fifth day of life. CSF changes suggested an encephalitis. Signs of neurologic and respiratory deterioration were followed by death. Partial cranial autopsy showed a necrohemorrhagic temporal encephalitis without intranuclear inclusions. Immunohistochemical examination by the avidin-biotin-peroxidase technique with polyclonal antibodies against Herpes simplex type 1 and type 2 was positive to type 2 Herpes simplex virus.

Key words: encephalitis, Herpes simplex virus, immunohistochemistry.

Full text available only in PDF format.

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Aceite: 24-novembro-1992.

Dra. Lígia M. Barbosa Coutinho Rua Carvalho» Monteiro 414 - 90470-100 Porto Alegre RS Brasil.

Estudo realizado no Departamento de Patologia da Fundação Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA) com auxílio do CNPq (Processo 403129/90-7)

1. Editorial. Acute diagnosis of Herpes simplex encephalitis. Lancet 1991, 337:205-206.
2. Anderson JR. Viral encephalitis and its pathology. In Adams JH, Anderson JR, Scholz CL, Weller RO (eds): Neuropathology. Berlin: Springer, 1988, p 24-57.
3. Aurelius E, Johansson B, Skvldenberg B, Staland A, Forsgren M. Rapid diagnosis of Herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid. Lancet 1891, 337:189-182.
4. Bell WE, McCormick WF. Herpes virus infection of the nervous system. In Bell WE, McCormick WF (eds): Neurologic infection in children. Ed 2. Philadelphia: Saunders, 1CS1, p 359-386.
5. Brick J F , Brick JE, Morgan JJ, Gutierrez AR. EEG and pathologic finding in patients undergoing brain biopsy for suspected encephalitis. Electroenceph Clin Neurophysiol 1990, 76:86-89.
6. Deo EA, Sardesai SR. Herpes simplex encephalitis. AFP 1988, 37:184-188.
7. Greenberg SB, Taber L, Steptimus E. Computadorized tomography in brain biopsy proven Herpes simplex encephalitis. Arch Neurol 1981, 38:58-59.
8. Klapeer PE, Cleator GM, Dennett C, Lewis AG. Diagnosis of encephalitis via southern blotting of cerebrospinal fluid DNA amplified by polymerase chain reaction. J Med Virol 1990, 32:261-264.
9. Khol S. Hespes simplex encephalitis in children. Ped Clin N Am 1988, 35:465-483.
10. Puchhammer-Stockl E, Popow-Kraupp T, Heinz FX, Mandl CW, Kunz C. Establishment of PCR for early diagnosis of Herpes simplex encephalitis. J Med Virol 1990, 32:77-82.
11. Rothman A, Cheeseman SH, Lehrman SN, Cederbaum A, Glew RH. Herpes simplex encephalitis in a patient with lymphoma. JAMA 1988, 259:1056-1057.
12. Rowley AH, Whitley RJ, Lakeman FD, Wolinsky SM. Rapid detection of Herpes simplex virus DNA in cerebrospinal fluid of patients with Herpes simplex encepahliatis. Lancet 1990, 335:440-441.
13. Smith MG, Lennette EH, Reames HR. Isolation of the virus of Herpes simplex and the demonstration of intranuclear inclusions in a case of acute encephalitis. Am J Pathol 1941, 17:55-68.
14. Staudt F. Perinatale Herpes simplex Infektion. Klin Paediatr 1988, 200:477-481.
15. Suares M, Labbe V, Phillips OM. Tipificación de la infección herpética por anticuerpos monoclonales y hemaglutinación indirecta. Rev Latioamer Microbiol 1988, 30:105-109.
16. Van Landingham KE, Marsteller HB, Ross GW, Hayden FG. Relapse of Herpes simplex encephalitis after convencional acyclovir therapy. JAMA 1988, 259:1051-1053.
17. Wasiewski WW, Fischmann MA. Herpes simplex encephalitis: the brain biopsy controversy. J Pediatr 1988, 113:575-578.
18. Whitley RJ. Herpes simplex virus infection of the central nervous system. Am J Med 1989, 85(Suppl 2A):61-67.
19. Whitley RJ, Cobbs CG, Alford CA. Diseases that mimic Herpes simplex encephalitis. JAMA 1989, 262:234-239.
20. Whitley RJ, Schlitt M. Encephalitis caused by Herpes viruses, including B virus. In Scheid WM, Whitley RJ, Durak DT (eds): Infections of the central nervous system. New York: Raven Press, 1991, p 41-86.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Set 1993

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Editorial. Acute diagnosis of Herpes simplex encephalitis. Lancet 1991, 337:205-206.

[2] 2. Anderson JR. Viral encephalitis and its pathology. In Adams JH, Anderson JR, Scholz CL, Weller RO (eds): Neuropathology. Berlin: Springer, 1988, p 24-57.

[3] 3. Aurelius E, Johansson B, Skvldenberg B, Staland A, Forsgren M. Rapid diagnosis of Herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid. Lancet 1891, 337:189-182.

[4] 4. Bell WE, McCormick WF. Herpes virus infection of the nervous system. In Bell WE, McCormick WF (eds): Neurologic infection in children. Ed 2. Philadelphia: Saunders, 1CS1, p 359-386.

[5] 5. Brick J F , Brick JE, Morgan JJ, Gutierrez AR. EEG and pathologic finding in patients undergoing brain biopsy for suspected encephalitis. Electroenceph Clin Neurophysiol 1990, 76:86-89.

[6] 6. Deo EA, Sardesai SR. Herpes simplex encephalitis. AFP 1988, 37:184-188.

[7] 7. Greenberg SB, Taber L, Steptimus E. Computadorized tomography in brain biopsy proven Herpes simplex encephalitis. Arch Neurol 1981, 38:58-59.

[8] 8. Klapeer PE, Cleator GM, Dennett C, Lewis AG. Diagnosis of encephalitis via southern blotting of cerebrospinal fluid DNA amplified by polymerase chain reaction. J Med Virol 1990, 32:261-264.

[9] 9. Khol S. Hespes simplex encephalitis in children. Ped Clin N Am 1988, 35:465-483.

[10] 10. Puchhammer-Stockl E, Popow-Kraupp T, Heinz FX, Mandl CW, Kunz C. Establishment of PCR for early diagnosis of Herpes simplex encephalitis. J Med Virol 1990, 32:77-82.

[11] 11. Rothman A, Cheeseman SH, Lehrman SN, Cederbaum A, Glew RH. Herpes simplex encephalitis in a patient with lymphoma. JAMA 1988, 259:1056-1057.

[12] 12. Rowley AH, Whitley RJ, Lakeman FD, Wolinsky SM. Rapid detection of Herpes simplex virus DNA in cerebrospinal fluid of patients with Herpes simplex encepahliatis. Lancet 1990, 335:440-441.

[13] 13. Smith MG, Lennette EH, Reames HR. Isolation of the virus of Herpes simplex and the demonstration of intranuclear inclusions in a case of acute encephalitis. Am J Pathol 1941, 17:55-68.

[14] 14. Staudt F. Perinatale Herpes simplex Infektion. Klin Paediatr 1988, 200:477-481.

[15] 15. Suares M, Labbe V, Phillips OM. Tipificación de la infección herpética por anticuerpos monoclonales y hemaglutinación indirecta. Rev Latioamer Microbiol 1988, 30:105-109.

[16] 16. Van Landingham KE, Marsteller HB, Ross GW, Hayden FG. Relapse of Herpes simplex encephalitis after convencional acyclovir therapy. JAMA 1988, 259:1051-1053.

[17] 17. Wasiewski WW, Fischmann MA. Herpes simplex encephalitis: the brain biopsy controversy. J Pediatr 1988, 113:575-578.

[18] 18. Whitley RJ. Herpes simplex virus infection of the central nervous system. Am J Med 1989, 85(Suppl 2A):61-67.

[19] 19. Whitley RJ, Cobbs CG, Alford CA. Diseases that mimic Herpes simplex encephalitis. JAMA 1989, 262:234-239.

[20] 20. Whitley RJ, Schlitt M. Encephalitis caused by Herpes viruses, including B virus. In Scheid WM, Whitley RJ, Durak DT (eds): Infections of the central nervous system. New York: Raven Press, 1991, p 41-86.