2014
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ΕΓΚΕΦΑΛΙΤΙΔΑ ΣΕ ΑΝΟΣΟΕΠΑΡΚΕΙΣ ΚΑΙ ΑΝΟΣΟΑΝΕΠΑΡΚΕΙΣ ΑΣΘΕΝΕΙΣ PowerPoint PPT Presentation


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ΠΑΙΔΙΑΤΡΙΚΕΣ ΛΟΙΜΩΞΕΙΣ 2014 ΣΑΒΒΑΤΟ 15 ΦΕΒΡΟΥΑΡΙΟΥ. ΕΓΚΕΦΑΛΙΤΙΔΑ ΣΕ ΑΝΟΣΟΕΠΑΡΚΕΙΣ ΚΑΙ ΑΝΟΣΟΑΝΕΠΑΡΚΕΙΣ ΑΣΘΕΝΕΙΣ. Ε.ΜΙΧΑΗΛΙΔΟΥ ΕΠΙΜΕΛΗΤΡΙΑ Α’ ΕΣΥ Γ’ ΠΑΙΔΙΑΤΡΙΚΗ ΚΛΙΝΙΚΗ ΑΠΘ Γ.Ν.ΙΠΠΟΚΡΑΤΕΙΟ. Η ομιλία αυτή δε χρηματοδοτήθηκε από καμία φαρμακευτική εταιρεία και δεν υπάρχει σύγκρουση συμφερόντων.

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ΕΓΚΕΦΑΛΙΤΙΔΑ ΣΕ ΑΝΟΣΟΕΠΑΡΚΕΙΣ ΚΑΙ ΑΝΟΣΟΑΝΕΠΑΡΚΕΙΣ ΑΣΘΕΝΕΙΣ

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2014

15

.

..


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?

,

  • (, )

  • (ADEM)

  • lethargica


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, , . , .

, .


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Clinical Infectious Diseases 2013;57(8):111428


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():

( , ) 24 ,

( >2 , 3 ):

  • 38C 72

  • 5 /mm3

  • ,

  • .

Consensus Statement of the

Intenational Encephalitis Consortium, CID 2013


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  • ( , )


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  • HSV 1 2

  • VZV

  • Epstein-Barr

  • 6

  • 7

  • Echo, Coxsackie, enteroviruses 9,71, polio

  • Reovirus

  • 1-3

  • RSV

  • 1,6,7,12,32

  • HumanCoronavirus

  • A,B,C

  • HumanParvovirus

  • Rotavirus

  • BK JC

Feigin and Cherry;s Textbook of Pediatrics


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Simian Herpesvirus (Herpesvirus B)

Hendra

Nipah

  • West Nile Virus

  • Tick-borne Encephalitis Virus

  • Eastern and Western Equine Encephalitis viruses

  • Japanese Encephalitis Virus, ..

Feigin and Cherrys Textbook of Pediatric Infectious Diseases, Sixth Edition Saunders, Elsevier 2009,

R.D. Feigin, J.D.Cherry, G.J.Demmler-Harrison, S.L.Kaplan


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  • spp

  • Bartonella Henselae

  • Listeria Monocytogenes

    • Borrelia Burgdorferi

    • Borrelia spp

Feigin and Cherrys Textbook of Pediatric Infectious Diseases, Sixth Edition Saunders, Elsevier 2009,

R.D. Feigin, J.D.Cherry, G.J.Demmler-Harrison, S.L.Kaplan


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  • Pneumoniae

  • Psittaci

    • Q

  • Pneumoniae

  • Hominis

    • Cryptococcus Neoformans

    • Coccidioides immitis

    • spp

    • spp

    • Naegleria spp

    • Toxoplasma gondii

    • Trichinella spiralis

    • Schistosoma spp

    • Strongyloides Srercoralis

Feigin and Cherrys Textbook of Pediatric Infectious Diseases,

Sixth Edition Saunders, Elsevier 2009,

R.D. Feigin, J.D.Cherry, G.J.Demmler-Harrison, S.L.Kaplan


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  • HSV1/2

  • HHV6

  • CMV HIV

  • VZV

  • JCPML ( )

  • ()


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,


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- 1

      • Gram

      • PCR HSV 1/2 ( IgM IgG)

      • PCR

Consensus Statement of the

Intenational Encephalitis Consortium, CID 2013


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- 2

    • EBV ( 2 15 )

  • (MRI)

    • PCR

    • PCR

Consensus Statement of the

Intenational Encephalitis Consortium, CID 2013


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- 3

    • <3 PCR Parechoviruses

    • :

        • PCR CMV

        • PCR HHV6

        • PCR HIV

      • / PCR

      • West Nile Virus

Consensus Statement

of the Intenational Encephalitis

Consortium, CID 2013


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- 4

    • : JE, ,

    • : TBE, WNV

    • : , ,

    • / : ,

    • : ,

Consensus Statement of the

Intenational Encephalitis Consortium, CID 2013


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H

  • Airway Breathing Circulation

  • , ,


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HSV (&VZV) :

- : 60mg/kg/24h ivq8, 14-21d

20-30 mg/kg/24h ivq8, 14-21d

:

-Foscarnet : 40 mg/kg/24h ivq8, 14-21d

CMV : + Foscarnet

:

: Pleconaril

Lassa HHV6


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Borrelia :

G iv 2-4w

:

:

:

( )

: / IVIG


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  • :

    -

    -

  • IVIG

  • HAART HIV PML ( ) JCV


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:

  • :

    (VZV, WNV)

    ( , )

  • :

    - 70%

    - 20-30%

    : 15-45%


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  • (JEV, TBEV)


Rthropod borne viruses

Rthropod-BOrne Viruses

Flaviviridae

  • West Nile

  • Tick-borne

Togaviridae

Alphavirus

  • Chikungunya

  • Western Equine Encephalitis

  • Eastern Equine Encephalitis

  • Venezuelan Equine Encephalitis

Bunyaviridae

  • Rift Valley Fever

  • Crimean-Congo

  • La Crosse


Tick borne encephalitis

TICK-BORNE ENCEPHALITIS


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  • 3-14

  • 80%

    • > 60


West nile 2010 2013

WEST NILE 2010-2013


Tick borne encephalitis1

Tick-Borne Encephalitis

  • ,

  • :


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  • >150

  • >60.000 ,

  • 40% <15

  • 150x106


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  • 1987 1970

  • 2012-2013 17

    • 14

    • 2

    • 1

      104

October 2012 March 2013. Euro Surveill.

2013;18(18):pii=20474. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20474


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  • :

    • ,

    • ,

    • , 4-12

    • , ,

    • 100%


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-


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LYME

  • 1977 Lyme

  • Borrelia burgdorferi


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LYME

  • 1 :

    • Erythema migrans

  • 2 :

  • 3 :

    • ( )

    • ,


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LYME -

  • :

    per os, 14-21d

    :

  • :

    G iv, 2-4w

  • :

    per os, 4w

  • :

    per os 4-8 w


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  • :

  • :


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