Non-congenital viral infections of the Central Nervous System: from the immunocompetent to the immunocompromised child.

Congress:

ECR 2020

Poster Number:

C-10280

Type:

Educational Exhibit

Keywords:

Multicentre study, Not applicable, Pathology, Inflammation, Infection, Education, MR-Diffusion/Perfusion, MR, Paediatric, Neuroradiology spine, Neuroradiology brain

Authors:

G. Moltoni¹, F. D'Arco², L. Pasquini¹, A. Romano¹, A. Bozzao³, C. Carducci¹, L. cursi¹, D. Longo¹, M. C. Rossi Espagnet⁴; ¹Rome/IT, ²London/UK, ³Roma/IT, ⁴Roma, RM/IT

DOI:

10.26044/ecr2020/C-10280

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-10280

Fig. 1: Schematic pattern-based representation of predominant Central Nervous System...

Fig. 5: 4-years-old girl, post-VZV infection. Axial DWI (A) and axial T2 (B) W images...

Fig. 6: 20-days old boy with dyspnea symptoms and seizures. Axial T2 images (A) shows...

Learning objectives

To describe MRI patterns of non-congenital Central Nervous System(CNS) viral infections in children and the complicated relationship between viral tropism and host response.

Background

The involvement of the CNS by a viral infection is a severe complication, associated with high morbidity and mortality. Recently, the incidence of encephalomyelitis has risen probably because of the increased use of immunosuppressive therapies and the reduction of vaccination rates [1]. Both virus and host characteristics may influence the probability of developing a CNS damage as well as its severity and location. Immunocompromised children, or neonates and preterm infants, are more susceptible to viral infections and may develop severe brain injuries. The diagnosis of...

Findings and procedure details

1. OVERVIEW In immunocompetent children, we schematically describe different MRI patterns related to the predominant viral tropism for one of these structures: cortical grey matter, deep grey matter, white matter, brainstem, cerebellum or spine.Fig. 1. However, it's important to remind that imaging patterns may overlap. In immunocompromised patients, lesions are usually more widespread with the involvement of both grey and white matter. 2. INFECTIONS IN IMMUNOCOMPETENT CHILDREN 2. 1 ENCEPHALITIS 2. 1. 1 Predominant cortical grey matter pattern Herpes Simplex Virus (HSV), especially type 1,...

Conclusion

Non-congenital viral CNS infections in children may result in different neuroimaging patterns depending on the viral tropism and host immune response. Viral tropism and host response themselves are influenced by numerous variables. In this scenario, the knowledge of the complex relations between the pathogen and the host and the recognition of neuroimaging patterns may help to narrow the possible aetiological diagnoses and assist the clinical management.

Personal information and conflict of interest

G. Moltoni; Rome/IT - nothing to disclose F. D'arco; London/UK - nothing to disclose L. Pasquini; Rome/IT - nothing to disclose A. Romano; Rome/IT - nothing to disclose A. Bozzao; Rome/IT - nothing to disclose C. Carducci; Rome/IT - nothing to disclose D. Longo; Rome/IT - nothing to disclose M. C. Rossi Espagnet; Rome, RM/IT - nothing to disclose L. Cursi; Rome/IT - nothing to disclose

References

George BP, Schneider EB, Venkatesan A (2014) Encephalitis Hospitalization Rates and Inpatient Mortality in the United States, 2000-2010. Baskin HJ & Hedlund G (2007)Neuroimaging of herpes virus infections in children. Pediatric Radiology, 37(10), 949–963. Lo CP & Chen CY (2008). Neuroimaging of Viral Infections in Infants and Young Children. Neuroimaging Clinics of North America, 18(1), 119–132. DOI:10.1016/j.nic.2007.12.002. Zuccoli G, Yannes MP, Nardone R, Bailey A, Goldstein A (2015) Bilateral symmetrical basal ganglia and thalamic lesions in children: an update (2015). Neuroradiology. Amarnath C, Helen Mary...