eISSN: 1509-572x
ISSN: 1641-4640
Folia Neuropathologica
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SCImago Journal & Country Rank
2/2020
vol. 58
 
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abstract:
Original paper

Morphological and ultrastructural changes in Herpes simplex encephalomyelitis: an attempt to determinate the etiological factor

Teresa Wierzba-Bobrowicz
1
,
Eliza Lewandowska
1
,
Paulina Felczak
1
,
Tomasz Stępień
1
,
Albert Acewicz
1
,
Sylwia Tarka
1, 2
,
Beata Błażejewska-Hyżorek
3
,
Agnieszka Bednarska
4
,
Ewa Matyja
5
,
Wiesława Grajkowska
6

1.
Department of Neuropathology, Institute of Psychiatry and Neurology, Warsaw, Poland
2.
Departament of Forensic Medicine, Medical University of Warsaw, Poland
3.
Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
4.
Department of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
5.
Department of Experimental and Clinical Neuropathology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
6.
Department of Pathology, Children’s Memorial Health Institute, Warsaw, Poland
Folia Neuropathol 2020; 58 (2): 143-150
Online publish date: 2020/06/30
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Herpes simplex encephalomyelitis (HSE) is a rare disease with a high mortality rate. Correct diagnosis is established on the basis of the combination of the clinical and investigative features. Unfortunately, precise diagnosis remains difficult due to several clinical similarities and false negative or inconclusive results of diagnostic tests. Here, we present two cases of HSE together with the morphological and ultrastructural picture. The first case was a 45-year-old man with acute symptoms of encephalitis, and the other one was a 28-year-old woman presenting subacute encephalomyelitis. Both cases had negative serologic and molecular results for Herpes simplex in the blood and cerebrospinal fluid. Brain and spinal cord samples taken from both cases were stained typically with histological and immunohistochemical methods and small tissue fragments were examined with the transmission electron microscope (TEM). Microscopic examination confirmed viral encephalomyelitis in both cases. An electron micrograph showed typical intranuclear viral particles inside of damaged neurons, which together with topography of brain and spinal cord changes suggest HHV-1/HHV-2 in the first case and/or HHV-3 in the other case. Thus, morphological and ultrastructural examinations may be a useful tool to set up correct diagnosis and help to determine the pathogenic factor in patients suspected of viral encephalomyelitis.
keywords:

encephalomyelitis, ultrastructure, microscopic, herpes simplex Introduction

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