1428. Myelitis and symmetrical Basal-Ganglia involvement associated with acute seroconversion to Sandfly Virus in Jerusalem, Israel
Session: Poster Abstract Session: CNS Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • IDSA poster 1428.pdf (957.6 kB)
  • Background: Sandfly viruses (SFV) are a group of closely related viruses which belong to the  Bunyaviridae. SVF are transmitted by the Phlebotomine sandflies. The currently known SFV  causing human diseases are Sicilian variant (SFSV), Naples variant (SFNV), the Toscana variant (TOSFV), and Cyprus variant (CSFV). The clinical presentation of infection by the sandfly virus group can vary from acute mild influenza-like symptomatology (Papatchi fever) to more severe form that might cause neurological involvement (mainly TOSFV). The neurological manifestations include meningitis, meningo-encephalitis or encephalitis.

    Methods: All patients with acute seroconversion to SFV at the Hadassah-Hebrew University Medical Centers were allocated and patient's clinical and imaging data was retrospectively collected and analyzed.

    Results: We identified 11 patients (1.5 to 85 years old) suffering from acute onset neurological symptoms and acute seroconversion to Sandfly virus.  Nine had clinical signs of meningitis, meningo-encephalitis, encephalitis or myelitis. Two patients showed signs of myelitis alone without clinical signs of meningitis or encephalitis. In six patients MRI either of the Brain, Spine or both were performed which identified pathological symmetrical changes in the Basal-Ganglia. Three patients had in addition changes consistent with myelitis in the spine. Acute seroconversion to more than single variant of SFV was identified in all. Nine patients had long term follow-up: Three completely recovered and Six patients had gradual recovery with some remaining neurological  sequela.

    Conclusion: Neurological involvement in SFV infections is usually considered to be benign. In our series of patients from Jerusalem, Israel, with acute seroconversion to SFV, 80% of the patients presented with major neurological pathology, including Myelitis and symmetrical Basal-Ganglia involvement, leading to permanent functional damage in some cases.

    We propose that in the presence of acute neurological symptoms with MRI pathology that included myelitis and/or symmetrical basal ganglia involvement, acute SFV infection should be included in the differential diagnosis.

    Chen Makranz1, Hiba Qutteineh1, John Gomori1, Hanna Bin2, Asaf Honig1, Abed El-Raouf Bayya1, Tamir Ben-Hur1, Diana Averbuch1, Roni Eichel1 and Ran Nir-Paz1, (1)Hadassah-Hebrew University Medical Center, Jerusalem, Israel, (2)Sheba Medical Center, Ramat Gan, Israel


    C. Makranz, None

    H. Qutteineh, None

    J. Gomori, None

    H. Bin, None

    A. Honig, None

    A. E. R. Bayya, None

    T. Ben-Hur, None

    D. Averbuch, None

    R. Eichel, None

    R. Nir-Paz, None

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