Unusual presentation of life-threatening Toscana virus meningoencephalitis.

This case report describes a brother and a sister with severe meningoencephalitis caused by Toscana virus (TOSv). The clinical presentation was characterized by stiff neck, deep coma, maculopapular rash, diffuse lymphadenopathy, hepatosplenomegaly, renal involvement, tendency to bleeding, and diffuse intravascular coagulation. The boy had epididymo-orchitis. Recovery with neurologic sequelae as hydrocephalus was observed. Microbiological diagnosis was obtained by serological tests and reverse transcriptase-polymerase chain reaction. Sequencing of polymerase chain reaction products from the S and M segments was carried out. TOSv may be a causative agent in severe meningoencephalitis.

[1]  M. G. Ciufolini,et al.  Evidence of Toscana virus circulation in Umbria: First report , 2002, European Journal of Epidemiology.

[2]  M. G. Ciufolini,et al.  Encephalitis without meningitis due to sandfly fever virus serotype toscana. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  F. Meacci,et al.  Detection of neurotropic viruses circulating in Tuscany: The incisive role of Toscana virus , 2000, Journal of medical virology.

[4]  M. G. Ciufolini,et al.  Detection of Toscana Virus-Specific Immunoglobulins G and M by an Enzyme-Linked Immunosorbent Assay Based on Recombinant Viral Nucleoprotein , 1999, Journal of Clinical Microbiology.

[5]  L. Santini,et al.  Laboratory Diagnosis of Toscana Virus Infection by Enzyme Immunoassay with Recombinant Viral Nucleoprotein , 1999, Journal of Clinical Microbiology.

[6]  L. Nicoletti,et al.  Humoral Response in Toscana Virus Acute Neurologic Disease Investigated by Viral-Protein-Specific Immunoassays , 1999, Clinical Diagnostic Laboratory Immunology.

[7]  J. Navarro-Marí,et al.  Infections due to sandfly fever virus serotype Toscana in Spain. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[8]  L. Santini,et al.  Evidence of Toscana Virus Variants Circulating in Tuscany, Italy, during the Summers of 1995 to 1997 , 1998, Journal of Clinical Microbiology.

[9]  K. Schimrigk,et al.  Toscana virus infection in german travellers returning from the mediterranean , 1997, Infection.

[10]  M. G. Ciufolini,et al.  Evidence of Toscana virus infections without central nervous system involvement: A serological study , 1997, European Journal of Epidemiology.

[11]  P. E. Valensin,et al.  Rapid identification of Toscana virus by nested PCR during an outbreak in the Siena area of Italy , 1996, Journal of clinical microbiology.

[12]  T. Schwarz,et al.  Immunoblot detection of antibodies to Toscana virus , 1996, Journal of medical virology.

[13]  H. Nitschko,et al.  Nested RT-PCR for detection of sandfly fever virus, serotype Toscana, in clinical specimens, with confirmation by nucleotide sequence analysis. , 1995, Research in virology.

[14]  T. Schwarz,et al.  Aseptic meningitis caused by sandfly fever virus, serotype Toscana. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  P. Di Bonito,et al.  Toscana virus genomic L segment: molecular cloning, coding strategy and amino acid sequence in comparison with other negative strand RNA viruses. , 1993, Virus research.

[16]  B. Niklasson,et al.  High prevalence rates of antibody to three sandfly fever viruses (Sicilian, Naples and Toscana) among Cypriots , 1991, Epidemiology and Infection.

[17]  M. G. Ciufolini,et al.  Central nervous system involvement during infection by Phlebovirus toscana of residents in natural foci in central Italy (1977-1988). , 1991, The American journal of tropical medicine and hygiene.

[18]  K. Takehara,et al.  Sequences and coding strategies of the S RNAs of Toscana and Rift Valley fever viruses compared to those of Punta Toro, Sicilian Sandfly fever, and Uukuniemi viruses. , 1991, Virology.

[19]  B. Niklasson,et al.  Incidence of sand fly fever among Swedish United Nations soldiers on Cyprus during 1985. , 1990, The American journal of tropical medicine and hygiene.

[20]  A. Weinberg,et al.  TOSCANA VIRUS INFECTION IN UNITED STATES CITIZEN RETURNING FROM ITALY , 1987, The Lancet.

[21]  C. Peters,et al.  NEUROVIRULENT TOSCANA VIRUS (A SANDFLY FEVER VIRUS) IN SWEDISH MAN AFTER VISIT TO PORTUGAL , 1985, The Lancet.

[22]  J. Casals,et al.  Techniques for hemagglutination and hemagglutination-inhibition with arthropod-borne viruses. , 1958, The American journal of tropical medicine and hygiene.

[23]  M. G. Ciufolini,et al.  Toscana virus infections of the central nervous system in children: a report of 14 cases. , 1998, The Journal of pediatrics.

[24]  M. G. Ciufolini,et al.  Phlebotomus-transmitted toscana virus infections of the central nervous system: a seven-year experience in Tuscany. , 1998, Scandinavian journal of infectious diseases.

[25]  D. Fortini,et al.  Organization of the M genomic segment of Toscana phlebovirus. , 1997, The Journal of general virology.

[26]  M. G. Ciufolini,et al.  ECOLOGY OF VIRUSES ISOLATED FROM SAND FLIES IN ITALY AND CHARACTERIZATION OF A NEW , 1988 .

[27]  M. G. Ciufolini,et al.  Antigenic and biological characterization of Toscana virus, a new Phlebotomus fever group virus isolated in Italy. , 1984, Acta virologica.