Identifikasi virus herpes simpleks pada anak dengan ensefalitis: sebuah studi pendahuluan

Rahmi Lestari, Andani Eka Putra

Abstract

Ensefalitis Herpes simpleks merupakan salah satu penyebab infeksi virus yang paling berat pada otak manusia. Tanpa terapi yang adekuat mortalitas mencapai 70% dan sebagian besar dari pasien yang bertahan hidup akan menderita sekuele neurologis berat. Data tentang prevalensi dan proporsi Herpes simpleks ensefalitis pada anak di Indonesia belum tersedia. Tujuan: Untuk menentukan proporsi ensefalitis Herpes simpleks pada anak dengan ensefalitis di RSUP M. Djamil Padang. Metode: Penelitian dilaksanakan di Instalasi Rawat Inap Anak RSUP M. DJamil Padang dari bulan Agustus hingga Desember 2016. Ensefalitis didefinisikan menurut konsensus International Encephalitis Consortium. Variabel yang dicatat meliputi usia, jenis kelamin, manifestasi klinis, dan luaran. Subjek dikatakan menderita ensefalitis Herpes simpleks bila hasil pemeriksaan polymerase chain reaction Herpes simpleks pada cairan serebro spinal memberikan hasil positif. Sebanyak empat belas orang anak memenuhi kriteria inklusi selama periode penelitian. Hasil: Manifestasi klinis yang paling sering ditemukan adalah demam, kejang, dan penurunan kesadaran. Sebagian besar subjek pulang dengan sekuele. Tidak ada virus Herpes simpleks yang ditemukan pada pemeriksaan PCR terhadap cairan serebrospinal. Kesimpulan: Tidak ada ensefalitis Herpes simpleks yang teridentifikasi pada penelitian ini. Dibutuhkan studi lebih lanjut dengan subjek yang lebih besar dan periode penelitian yang lebih panjang untuk mendapatkan gambaran besarnya masalah ensefalitis Herpes simpleks pada anak di Indonesia.

Keywords

ensefalitis; herpes simpleks; insiden

Full Text:

PDF

References

Britton PN, Eastwood K, Paterson B, Gurrheim DN, Dale RC, Cheng AC. Consensus guidelines for the investigation and management of encephalitis in adults and children in Australia and new Zealand. Internal Medicine Journal 2015; 45:563-576.

Kneen CR, Michael BD, Menson E, Mehta B, Easton A, Hemingway C. Management of suspected viral encephalitis in children – Cassociation of British Neurologists andbritish Paediatric Allergy Immunology and Infection Group National Guidelines. J Infect 2012; 64:449-477.

Whitley RJ, Kimberlin DW. Herpes simplex: encephalitis children and adolescents. Semin Pediatr Infect Dis 2005; 16:17-23.

Whitley J. Herpes simplex encephalitis: adolescents and adults. Antiviral Research 2006; 71:141-148.

Bale JF. Viral infection of the nervous system. In: Swaiman KF, Ashwal S, Ferriero DM, Schor NF. Swaiman’s pediatric neurology. 5th edition. London: Saunders. 2012; p.1262-1290.

Venkatesan A, Tunkel AR, Bloch KC, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis 2013; 57: 1114-28.

VanDevanter DR, Warrener P, Bennett L, Schultz E, Coulter S, Garber RL, Rose TM. Detection and analysis ofdiverse Herpesviral species by consensus primer PCR. J Clin Microbiology 1996;34:1666-71.

Granerod J, Cousens S, Davies NWS, Crowcroft NS, Thomas SL. New estimates of incidence of encephalitis in England. Emerg Infect Dis 2013; 19: 1455-62.

Pusponegoro HD. Ensefalitis herpes simplex pada anak. Sari Pediatri. 2000;77:77-81.

De Tiege X, Heron B, Lebon P, Ponsot G, Rozenberg F. Limits of early diagnosis of herpes simplex encephalitis in children: a retrospective study of 38 cases. Clin Infect Dis 2003; 36:1335-9.

Solomon T, Hart IJ, Beeching NJ. Viral encephalitis: a clinician’s guide. Pract Neurol 2007; 7:288-305.

Nigrovic LE, Shah SS, Neuman MI. Correction of cerebrospinal fluid protein for the presence of red blood cells in children with a traumatic lumbar puncture. J Pediatr 2011; 159:158-9.

Whitley RJ, Lakeman F. Herpes simplex virus infections of the central nervous system: therapeutic and diagnostic considerations. Clin Infect Dis 1995; 20:414-20.

Bitnun A, Ford-jones EL, Petric M, et al. Acute childhood encephalitis and Mycoplasma pneumoniae. Clin Infect Dis 2001 Jun 15; 32:1674-84.

Lakeman FD, Whitley RJ. Diagnosis of Herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid frombrain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. J Infect Dis 1995; 171:857-63.

Adler AC, Kadimi S, Apaloo C, Marcu C. Herpes simplex encephalitis with two false –negative cerebrospinal fluid PCR tests and review of negative PCR results in the clinical setting. Case Rep Neurol 2011; 3:172-8.

Gkrania-Klotsas E, Lever AML. Herpes simplex I encephalitid presentingas a brain haemorrhage with normal cerebrospinal fluid analysis: a case report. J Med Case Reports 2008; 2:387.

DeBiasi RL, Kleinschmidt-DeMasters BK, Weinberg A, Tyler KL: Use of PCR for the diagnosis of herpesvirus infections of the central nervous system. J Clin Virol 2002; 25:S5-S11.

Puchhammer-Stockl E, Presterl E, Croy C, Aberle S, Popow-Kraupp T, Kundi M, Hofmann H, Wenninger U, Godl I: Screening for possible failure of herpes simplex virus PCR in cerebrospinal fluid for the diagnosis of herpes simplex encephalitis. J Med Virol 2001; 64:531–536.

Selvaraju SB, Wurst M, Horvat RT R.S.: Performance of three different HSV ID/typing assays for detection and typing of herpes simplex virus in cerebrospinal fluid. Diagn Microbiol Infect Dis 2009; 63:286-291.

Domingues RB, Lakeman FD, Mayo MS, Whitley RJ: Application of competitive PCR to cerebrospinal fluid samples from patients with herpes simplex encephalitis. J Clin Microbiol 1998; 36:2229-2234.

Puchhammer-Stockl E, Heinz FX, Kundi M, Popow-Kraupp T, Grimm G, Millner MM, Kunz C: Evaluation of the polymerase chain reaction for diagnosis of herpes simplex virus encephalitis. J Clin Microbiol 1993; 31:146-148.

Denes E, Labach C, Durox H, Adoukonou T, Weinbreck P, Magy L, Ranger-Rogez S: Intrathecal synthesis of specific antibodies as a marker of herpes simplex encephalitis in patients with negative PCR. Swiss Med Wkly 2010; 140:E1-E4.

Schlede L, Bueter W, Baumgartner S, et al. Pediatric Herpes simplex encephalitis: a retrospective multicenter experience. J Child Neurol 2013; 28:321-31.

Beig FK, Malik A, Rizvi M, Acharya D, Khare S. Etiology and clinic-epidemiologycal profile of acute viral encephalitis in children of Western Uttar Pradesh, India. Int J Infect Dis 2010; 14:e141-6.



-->