[Low-manifest infections with CNS damage in patients in prolonged unconscious state of non-inflammatory etiology].
OBJECTIVE
Study of specter of low-manifest infections (LMI) with central nervous system (CNS) damage and their role in patients in prolonged unconscious state (PUS) of noninflammatory etiology.


METHODS
32 patients (23 male, 9 female; age 14-58) in PUS of various etiology were examined. The main group (18 patients) received therapy against all infectious diseases including LMI; control group (14 patients)--only against common and nosocomial microflora. Patients were immunologically, infectologically and neurologically examined in dynamic. The data obtained were treated by using STATISTICA for Windows (version 5.5).


RESULTS
Significant differences in immune and infectologic status depending on the nature of primary CNS damage were not detected. Immunodeficiency was detected in all patients; 94% of patients had increased non-specific IgM and IgE. Among LMI agents Chlamydia spp. were predominant. Cultural and/or PCR methods detected this microorganism during the primary examination in cerebrospinal fluid samples in 56% patients and in blood samples in 56%; during the second diagnostics or autopsy--only in 13 and 25%, respectively. Detection of Bacteroides fragilis, Human Herpes Virus (HHV-6), Virus Epstein Barr (VEB), Cytomegalovirus (CMV) in cerebrospinal fluid, blood and on mucous membranes of nasopharynx and conjunctiva was grouped more frequently with the presence of Chlamydia spp. in the CNS (p < 0.05) than with other LMI agents. Sanation of CNS from LMI was significantly accompanied by regeneration of communicative activity in comparison with the control group.


CONCLUSIONS
In patients with PUS high frequency of CNS infection by various LMI agents and primarily Chlamydia spp. should be considered. Sanation from LMI can become a "window" for effective neuro-regenerative treatment.
Iu I
IuI
Vaĭnshenker
I M
IM
Ivchenko
V A
VA
Tsinzerling
I V
IV
Nuralova
O V
OV
Khlopunova
L A
LA
Berezina
L B
LB
Kuliashova
A A
AA
Viazovaia
O V
OV
Kalinina
A D
AD
Korotkov
G V
GV
Kataeva
S V
SV
Medvedev
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage; D001424:Bacterial Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000821:virology; D001441:Bacteroides fragilis / Q000235:genetics / Q000302:isolation & purification; D002490:Central Nervous System / Q000382:microbiology / Q000473:pathology / Q000821:virology; D002494:Central Nervous System Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000821:virology; D002689:Chlamydia / Q000235:genetics / Q000302:isolation & purification*; D060085:Coinfection; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D014474:Unconsciousness / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000821:virology; D014777:Virus Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000821:virology
D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D004269:DNA, Bacterial; D004279:DNA, Viral