Neurologic Alterations Due to Respiratory Virus Infections

Bohmwald, Karen; Gálvez, Nicolás M. S.; Ríos, Mariana; Kalergis, Alexis M.

From this point on, several cases were described where hMPV-infection was related to encephalitis, and in some cases, the detection of genetic material in different CNS samples was detected. The year 2007, the death of a 6-month-old girl was reported 9 days after her admission to a healthcare unit (Hata et al., 2007) . She exhibited generalized convulsions and was diagnosed with acute encephalopathy the day she was admitted, and 24 h later she fell into a coma. Although there was no detection of genetic material in CSF, the presence of hMPV-F protein was confirmed by RT-PCR in throat swab and urine (Hata et al., 2007) . Two years later, Arnold et al. (2009) described in an epidemiological report the presence of nine cases of hMPV-infection related to different spectrums of CNS abnormalities, distributed in two different study groups. In the first group, composed of 1474 patients, 76 samples were hMPV positive, and of those, four patients were reported with seizures. Therein, they also expose data regarding hRSV, showing that 145 of the samples were positive for this virus and only one of the patients was reported with seizures. Through statistical analysis, they can confirm that the frequency of hMPV patients with seizures is statistically significant, unlike the one has seen in hRSV. The second group consisted solely of patients hospitalized with high fever or any CNS abnormality, ranging from the age of 6-month-old to 18 years old. In that group, they reported five patients with hMPV, where seizures were diagnosed in three (Arnold et al., 2009) . They also described another patient with hMPV-infection and detection of genetic material of enterovirus in CSF. Remarkably, the presence of hMPV genetic material was not detected in the CSF of any of the available samples. Despite this, they indicate that a normal CSF profile does not necessarily exclude a neurotropic mechanism, as seen for rabies encephalitis, in which only half of the CSF samples are positive for CSF pleocytosis (Arnold et al., 2009) . Likewise, the case reported above by Schildgen et al. (2005) identified hMPV RNA postmortem, despite normal CSF cell count and a negative detection of the virus by PCR in spinal fluid (Arnold et al., 2009 ).