Fatal herpesvirus tamarinus infection in cotton-topped marmosets (Saguinus oedipus).

Fatal herpesvirus tamarinus infection was observed in cotton-topped marmosets (Saguinus oedipus) imported from South America via the United States on August 26, 1976. In addition to the lesions hitherto reported in herpesvirus tamarinus infection, severe degenerative and necrotic changes of ganglion cells were recognized with intranuclear inclusion bodies in the plexus of the digestive tract and the sympathetic nerves and their ganglions in the abdominal cavity. Inflammatory or regressive changes were also noted in the central nervous system. A large number of basophilic or eosinophilic intranuclear inclusion bodies frequently recognized in multinucleated giant cells were observed in various organs and tissues, and they showed different shapes at the electron microscopic level. Morphological findings indicated that herpesvirus tamarinus infection seemed to be similar to herpes simplex virus infection in man. The findings of the susceptibility of a variety of cell cultures to the virus isolate serologically identified as herpesvirus tamarinus and physicochemical characteristics of the virus isolate were in general agreement with the findings of herpesvirus tamarinus already reported by previous workers.     

The landscape of extrapulmonary manifestations of human parainfluenza viruses: A systematic narrative review

Human parainfluenza virus (HPIV) infection is associated with every kind of respiratory tract illnesses, including the common cold, laryngotracheobronchitis (i.e. croup), tracheobronchitis, bronchiolitis, and pneumonia, in both children and adults. Although HPIVs are common respiratory pathogens, there are increasing reports about extrapulmonary manifestations of HPIVs infection. Each of the HPIVs could produce infection of other organs (central nervous system, heart, myocardium, etc.) in all age groups who are either immunocompetent or immunocompromised. This review aimed at summarizing the available data on clinical manifestations of HPIV infection outside the respiratory tract from 1961 to 2020. The findings support the possibility of extrapulmonary infections that were thought to be due to rare host genetic or immunologic defects in infected patients. These findings highlight the fact that extrapulmonary dissemination of HPIV can occur, but the association is not clearly demonstrated. Our data support the hypothesis that HPIV infection is one of the possible causes of these alterations and may even be the direct cause in some cases.     

Respiratory nosocomial infections in the medical intensive care unit

Intensive care unit (ICU)-acquired lower respiratory tract infections include acute tracheobronchitis and hospital-acquired and ventilator-associated pneumonia (VAP). Nosocomial pneumonia is the second most common hospital-acquired infection and the leading cause of death in hospital-acquired infections. The mortality rate in VAP ranges from 24% to 76% in several studies. ICU ventilated patients with VAP have a 2- to 10-fold higher risk of death than patients without it. Early oropharyngeal colonization is pivotal in the etiopathogenesis of VAP. The knowledge of risk factors for VAP is important in developing effective preventive programs. Once the physician decides to treat a suspected episode of ICU-acquired pneumonia, some issues should be kept on mind: first, the adequacy of the initial empiric antibiotic therapy; second, the modification of initial inadequate therapy according to microbiological results; third, the benefit of combination therapy; and finally, the duration of the antimicrobial treatment. Additionally, a protocolized work-up to identify the causes of non-response to treatment is mandatory. All these issues are discussed in depth in this article.     

Recovery of a new herpesvirus from the ground squirrel (Citellus citellus).

A new herpesvirus recovered from the kidneys of mature ground squirrels (Citellus citellus) produced an effect in tissue culture cells resembling that of herpesviruses, including the formation of multinucleated syncytia and type A intranuclear inclusions. The isolate caused latent infection in the natural host, but it proved fatal for intracerebrally inoculated suckling mice and it produced pocks on the chorioallantoic membrane of embryonated eggs. Electron-microscopic examination of infected cells revealed intranuclear virus particles exhibiting a size and ultrastructure characteristic of herpesviruses. The isolate was ether-resistant and a DNA nucleic acid type was inferred from observations on inhibition by fluorinated pyrimidine. This ground squirrel herpesvirus was found to be antigenically distinct from Herpesvirus hominis and from ground squirrel cytomegalovirus, with no detectable cross-reactivity.     

Lethal pneumonia in guinea pigs associated with a virus

No bacteria were observed in an epizootic of lethal pneumonia in guinea pigs. Necrotic bronchitis and bronchiolitis with basophilic intranuclear inclusion bodies in bronchial epithelial cells were characteristic. Although adenovirus infection of guinea pigs has not previously been reported, histological findings paralleled those found in adenovirus infections of other animals including man. Virus particles found by electron-microscopical examination of the lung tissue closely resembled adenoviruses. The disease seemed to have a low contagiousness, a low morbidity (about 0.7%), but an acute course and a high mortality (100%).     

Toxoplasmosis, distemper, and herpesvirus infection in a skunk (Mephitis mephitis).

A striped skunk (Mephitis mephitis) showing abnormal behavior had histopathologic lesions of toxoplasmosis and canine distemper in addition to intranuclear, eosinophilic inclusions in the reticuloendothelial cells of the spleen, liver and lung. The inclusions, on electron microscopic examination, were compatible with herpesvirus infection.     

Protective effects of nasal immunization in mice with various kinds of inactivated Sendai virus vaccines

The immunoprophylactic effects of nasal vaccination with 13 different kinds of inactivated Sendai virus vaccines were compared by contact exposure to infector mice. Efficacies of the vaccines were evaluated on the basis of the presence of virus-infected cells by immunofluorescent examination of the entire respiratory tract, including the nasal mucosa. A single or double inoculations of B-propiolactone (0.5%)-vaccine promoted the infection in the respiratory tract, particularly in the nasal mucosa, whereas three inoculations of B-propiolactone (0.2%)-vaccine provided considerable protection throughout the respiratory tract with only slight development of serum HI titer. Formalin (0.1%)-vaccine and UV irradiated-vaccine strongly protected the nasal mucosa from infection, but did not sufficiently safeguard the lower respiratory tract even with three vaccinations despite adequate development of serum antibody. Nearly complete protection of the entire respiratory tract was induced with six to eight inoculations of a vaccine treated excessively with both UV rays and 1% formalin, without significant development of serum antibody. Out of eight thermal vaccines, five (inactivated at 23 C, 30 C, 37 C and 7 C, and 30 C and 7 C) provided strong protection against infection when inoculated three times. The others inactivated at higher temperatures (37 C, 50 C, or 60 C) were not so protective. High serum HI titers developed, on the whole, with the drop in the temperature required for inactivating the virus. In eight immune mouse groups in which infection was strongly suppressed in the entire respiratory tract, most of the mice harbored less than 50 viral antigen-positive cells in their nasal mucosa in the postexposure period. The number of the cells was assumed to be a useful criterion for evaluation of vaccine efficacy.     

Immunological responses of hamsters in the acquired immune state to Mycoplasma pneumoniae infection

Protective effects of vaccination of hamsters against Mycoplasma pneumoniae infection, evaluated according to the recovery of mycoplasmas and histopathological changes in the respiratory tract after challenge infection, persisted for at least 6 months after the final vaccination. Serum antibody levels reached a maximum in the second week after the last vaccination and decreased markedly between the first and the third months, but increased again in sera obtained from animals given booster injections. Metabolism-inhibiting antibodies were detected in bronchial washings of animals showing high resistance obtained by vaccinal or passive immunization. Antiserum transfer was also effective for protection but cell-mediated immune responses were not demonstrated in any animals up to 6 months after the vaccination. Even after 10 months, suppression of both mycoplasmal proliferation and lung lesions was apparent, and a single dose of the vaccine induced a significant booster effect. These findings suggest that (1) humoral immunity is more important than cell-mediated immunity in resistance of hamsters to M. pneumoniae pneumonia, and (2) the antibody secreted in the respiratory tract may be involved in the local defense mechanisms.     

Probable herpesvirus infection in an eastern cottontail (Sylvilagus floridanus).

One wild eastern cottontail (Sylvilagus floridanus) from Milwaukee County, Wisconsin was necropsied. The lungs contained numerous multifocal, circumscribed, tan foci; the spleen was markedly enlarged and had a mottled reddish tan color; and the brain had a red to tan friable tract in the left hemisphere. Microscopically, the lung had a severe bronchiolitis and pneumonia. The bronchiolitis was characterized by epithelial cells containing eosinophilic intranuclear inclusion bodies. The encephalomalacia of the left cerebral cortex featured tissue disruption and astrocytes or neurons containing intranuclear inclusion bodies. Herpesvirus particles were found within the bronchiolar epithelial cells. Based on histopathological and ultrastructural findings, a herpesvirus seemed the most likely etiologic agent.     

Infection with a novel gammaherpesvirus in northern elephant seals (Mirounga angustirostris)

Twenty juvenile northern elephant seals (Mirounga angustirostris) that died between 1998 and 2004 had ulcers on the tongue, palatine mucosa, and/or tonsils. Histologic examination of the lesions revealed cytoplasmic swelling, nuclear pyknosis, and eosinophilic to amphophilic intranuclear inclusions bodies suggestive of herpesviral infection. Electron microscopic examination and polymerase chain reaction analysis confirmed the presence of a herpesvirus. Subsequent DNA sequencing identified this to be a new gammaherpesvirus that was similar to Porcine lymphotropic virus 2, Alcephaline herpesvirus 1 (malignant catarrhal fever virus from wildebeest), and Chlorocebus rhadinovirus 1 from African green monkeys. Identical herpesviral DNA was also detected in blood and mucosal swabs collected from five healthy elephant seal pups.     

Streptococcus pneumoniae Enhances Human Respiratory Syncytial Virus Infection In Vitro and In Vivo

Human respiratory syncytial virus (HRSV) and Streptococcus pneumoniae are important causative agents of respiratory tract infections. Both pathogens are associated with seasonal disease outbreaks in the pediatric population, and can often be detected simultaneously in infants hospitalized with bronchiolitis or pneumonia. It has been described that respiratory virus infections may predispose for bacterial superinfections, resulting in severe disease. However, studies on the influence of bacterial colonization of the upper respiratory tract on the pathogenesis of subsequent respiratory virus infections are scarce. Here, we have investigated whether pneumococcal colonization enhances subsequent HRSV infection. We used a newly generated recombinant subgroup B HRSV strain that expresses enhanced green fluorescent protein and pneumococcal isolates obtained from healthy children in disease-relevant in vitro and in vivo model systems. Three pneumococcal strains specifically enhanced in vitro HRSV infection of primary well-differentiated normal human bronchial epithelial cells grown at air-liquid interface, whereas two other strains did not. Since previous studies reported that bacterial neuraminidase enhanced HRSV infection in vitro, we measured pneumococcal neuraminidase activity in these cultures but found no correlation with the observed infection enhancement in our model. Subsequently, a selection of pneumococcal strains was used to induce nasal colonization of cotton rats, the best available small animal model for HRSV. Intranasal HRSV infection three days later resulted in strain-specific enhancement of HRSV replication in vivo. One S. pneumoniae strain enhanced HRSV both in vitro and in vivo, and was also associated with enhanced syncytium formation in vivo. However, neither pneumococci nor HRSV were found to spread from the upper to the lower respiratory tract, and neither pathogen was transmitted to naive cage mates by direct contact. These results demonstrate that pneumococcal colonization can enhance subsequent HRSV infection, and provide tools for additional mechanistic and intervention studies.     

Cytology of pleural effusion associated with disseminated infection caused by varicella-zoster virus in an immunocompromised patient. A case report

BACKGROUND: Pleural effusion caused by varicella-zoster virus (VZV) is rare. We report a case of a woman with acute lymphocytic leukemia (ALL) who developed a pleural effusion caused by VZV infection. CASE: A 55-year-old woman with ALL treated with consolidation therapy developed skin vesicles and a pleural effusion. Pleural fluid smears contained numerous mesothelial cells, which had ground-glass nuclei or eosinophilic nuclear inclusions. Some multinucleated giant cells were also seen. Electron microscopic examination revealed intranuclear virus particles, about 150 nm in diameter, in some mesothelial cells. Tissue samples from the skin, lungs, pleura, liver, pancreas, kidneys and gastrointestinal tract, obtained at autopsy, contained many virus-infected cells. They were positive for VZV glyco-protein 1 by immunohistochemistry. CONCLUSION: VZV infection should be considered in the differential diagnosis of an unexplained exudative pleural effusion, especially in immunocompromised hosts.     

Cycloferon efficacy in viral and bacterial diseases of children (clinical review)

The authors' findings and literature data on the pharmacotherapeut efficacy of cycloferon, an interferon inductor (immunomodulators) are described. The drug effect in the treatment of various socially significant children' diseases, including acute respiratory tract viral infection, bronchial asthma, allergic conditions with infection protection disturbances, mycoplasmic infection, bronchopulmonary complications of acute respiratory tract viral infection with low intensity of free radical oxidation is indicated. The use of cycloferon at the background of vaccination was shown to provide inhibition of the autoimmune processes causing postvaccinal complications in frequently ill children. The results of the use of cycloferon in the treatment of gastrointestinal tract and intestinal infections of both the viral and bacterial genesis are discussed. Cycferon is recommended to be used for correction of the intestine dysbiosis (the microflora level came to normal in 95% of the children). The use of the drug in surgical pathology and in particular in appendicular peritonitis for decreasing the postoperative complications and correction of the immune disturbances due to chronic viral hepatitis C and B in children under the complex therapy is described. The cycloferon safety and efficacy were confirmed by the postmarketing randomized trials.     

Rational antimicrobial pharmacotherapy of secondary infections in patients with pulmonary tuberculosis]

The results of 3-year (2002-2004) local microbiological monitoring of secondary infections due to opportunistic microflora that complicated the treatment of the main disease in patients of a regional (Moscow) tuberculosis hospital are presented. The monitoring revealed the leading microorganisms, the etiological agents of the secondary lower respiratory tract infection in the patients with pulmonary tuberculosis. The level of their resistance to the up-to-date antimicrobials was determined. Recommendations for optimization of antibacterial therapy of patients with pulmonary tuberculosis complicated by secondary lower respiratory tract infection due to opportunistic microorganisms were developed and validated.     

Gramnegative opportunistic microflora as etiological factor of secondary infection in patients with pulmonary tuberculosis]

The results of the laboratory diagnoses of respiratory tract secondary infections in patients with pulmonary tuberculosis within a period of 12 months in a tuberculosis clinic were generalized. The species composition of the causative agents of lower respiratory tract secondary infection and the frequency of their detection in various clinical speciments (sputum, bronchial washings) were determined. The data on resistance of the opportunistic gramnegative bacilli (enterobacteria, pseudomonads, Acinetobacter spp.) isolated from the patients with pulmonary tuberculosis to various groups of antibacterials are presented.     

Psittacosis in Manitoba

Paired blood specimens submitted to the Virus Laboratory, between January and September 1970, from 200 patients with a lower respiratory tract infection were examined for antibodies to the psittacosis-human pneumonitis group antigen. A high static titre of antibodies was found in four patients and a rising titre in three. The illness varied in the seven patients, tending to be severe, chronic and recurrent. All patients recovered following a course of antibiotic therapy which was repeated in four; treatment tended to be inadequate since the diagnosis of psittacosis was made retrospectively. The likely source of the infection in four of the patients was budgerigars, in one it was pigeons, in one it was a canary as well as a pigeon, and in one the source was not identified. Two additional patients had a fairly high static titre of antibodies to the psittacosis-human pneumonitis antigen but were excluded from this report since they showed a diagnostic increase in antibodies to a respiratory virus during the course of their illness; both patients had an avian contact and are being followed up.     

Vaccine-induced immunopathology during bovine respiratory syncytial virus infection: exploring the parameters of pathogenesis

The bovine and human respiratory syncytial viruses cause severe lower respiratory tract infections. Effective vaccines against the respiratory syncytial viruses have been lacking since vaccine failures in the 1960s and 1970s. In this report, we describe a bovine respiratory syncytial virus (bRSV) challenge model in which both classical bRSV respiratory infection and vaccine-enhanced immune pathology were reproduced. The classical, formalin-inactivated (FI) bRSV vaccine that has been associated with vaccine failure was efficient in inducing high antibody titers and reducing viral loads but also primed calves for a far more serious enhanced respiratory disease after a bRSV challenge, thereby mimicking the enhanced clinical situation in FI human RSV (hRSV)-immunized and hRSV-infected infants in the 1960s. We show that immunization with FI-bRSV mainly primes a Th2-like inflammatory response that is characterized by a significant eosinophilic influx in the bronchial alveolar lung fluid and lung tissues and high levels of immunoglobulin E serum antibodies. The current model may be useful in the evaluation of new bRSV candidate vaccines for potency and safety.     

Outbreak of human herpesvirus type 1 infection in nonhuman primates (Callithrix penincillata)

Human herpesvirus type 1 (HHV-1) is widely dispersed among the human population. Although infection is often asymptomatic in humans, nonhuman primates develop a severe and often fatal infection. In August 2006, 13 black-tufted marmosets (Callithrix penincillata) from a group of 14 presented with clinical apathy, anorexia, and ataxia. Physical examination revealed conjunctivitis, erosive or ulcerative lesions on the skin, and swollen lymph nodes. Of the 14 animals captured, 10 died. Grossly, ulcers and erosions were observed on the skin of face, nasal planum, lips, and oral mucosa. Histologically, superficial vesicular and erosive stomatitis with associated basophilic intranuclear inclusion bodies in the squamous epithelium were observed. Swabs from oral lesions and tissue samples from necropsied animals were positive for HHV-1 by nested polymerase chain reaction for eight animals.     

BIRD POPULATION STUDIES.-V. FIVE CONSECUTIVE DAILY COUNTS OVER 21 ACRES IN NORTHERN RHODESIA

Williams, M.C. &; Nesbit, J.W. 1996. Fatal herpesvirus infection in a Cape Eagle Owl Bubo capensis and a Spotted Eagle Owl Bubo africanus. Ostrich 67:50-62

Fatal, systemic herpesvirus infection was reported in a Cape Eagle Owl Bubo capensis and a Spotted Eagle Owl Bubo africanus. This is believed to be the first report of systemic herpesvirus infections in owls in South Africa. Post mortem examinations revealed multifocal necrosis in the liver and spleen. Histologically, intranuclear inclusion bodies were present, particularly in cells at the periphery of necrotic foci. Typical herpesvirus virions, demonstrable by transmission electron microscopy, were present. Viral isolations were unfortunately not undertaken.     

Pseudomonas aeruginosa colonisation in an intensive therapy unit: role of cross infection and host factors.

Despite the sparsity of Pseudomonas aeruginosa in the environment colonisation and infection with this organism was found at several sites by selective culture in 20 out of 46 patients in an intensive therapy unit. Three patients developed Ps aeruginosa pneumonia. Serial serogrouping and phage typing identified multiple strains in the unit and in the same patient. Rectal carriage occurred in 16 patients but rectal strains did not subsequently appear in tracheal aspirates; strains varied in their affinity for the upper respiratory tract. Colonisation was not directly related to length of stay and was detected in 16 of those colonised within 24 hours of admission. In intubated patients, who were colonised more frequently than those not intubated, upper respiratory tract colonisation correlated strongly with low initial arterial pH values. Personnel were probably responsible for cross infection among patients when the unit was busy. Strain differences and the susceptibility of patients also influenced colonisation and infection. Elimination of major reservoirs of Ps aeruginosa and compliance with procedures to control cross infection remain essential if patients in hospital are to escape colonisation by the organism.