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Summary: Sequential sera from a patient with primary Herpes Simplex Virus type I (HSV-1) encephalitis and a patient with HSV-1 recurrent oral lesions were collected. Sera were analyzed quantitatively by radioimmunoassay and qualitatively by electrophoresis and autoradiography of immune precipitates to determine the sequence of antibody production to specific radiolabeled HSV-1 polypeptide and glycoprotein antigens. The major antibody response in both primary and recurrent sera was against HSV-1 envelope antigens and the major capsid polypeptide. Sequential sera showed a significant correlation between neutralizing antibody titers and quantitative antibody to HSV-1 glycoproteins. Qualitative electrophoretic analysis of primary infection sera showed sequential appearance of antibodies to increasing numbers of HSV-1 polypeptides by the fourteenth day of infection. A corresponding qualitative antibody response to glycoproteins was not seen. Sequential sera obtained before, during, or after a recurrent lip lesion in another patient showed no significant quantitative or qualitative changes in antibodies to either HSV-1 glycoproteins or polypeptides.Speculation: A qualitative variation in antibody response to Herpes Simplex Virus polypeptides develops following a primary infection. The lack of qualitative variation in antibody response to recurrent infection provides a means of distinguishing primary from recurrent Herpes Simplex Virus infections.

Extract: The rabbit model of Herpesvirus hominis (HVH) encephalitis was utilized to determine whether thymidine (TdR) kinase (EC. 2.7.1.2.1), an early enzyme in the HVH replicative cycle, is present in the cerebrospinal fluid (CSF) of rabbits with HVH encephalitis. The mean TdR kinase activity in CSF from infected rabbits was 2.30 ± 1.69 pmol product/120 min/100 µl CSF, while the mean TdR kinase activity of uninfected CSF was 0.34 ± 0.25. The enzyme appeared to be cell associated since the TdR kinase activity in the sedimented cell suspension was 5.08 ± 2.93 (seven values) while the supernatant activity was 0.14 ± 0.31 (seven values). To allow a comparison of TdR kinase from infected rabbit CSF with HVH and rabbit mononuclear cell TdR kinase, the mean ratio of TdR kinase activity at pH 6.0/pH 8.0 was calculated. The mean ratio of thymidine kinase activity, pH 6.0/pH 8.0, for infected rabbit CSF is intermediate between the ratio for HVH TdR kinase (P < 0.001) and rabbit mononuclear cell TdR kinase (P < 0.05).Speculation: The presence of TdR kinase in CSF from HVH-infected rabbits with biochemical properties intermediate between HVH and mononuclear cell TdR kinase suggests that abortive HVH infection occurs in CSF mononuclear cells during the course of HVH encephalitis.

Twenty-nine children who had had California encephalitis were evaluated for intellectual functioning and visual-motor coordination two years after discharge from the hospital. They were compared with an equal number of out-patients selected from psychology files. For nine of the study patients, pre-illness measures were available for comparison.No uniform effects of the illness were identified. The number of symptoms and laboratory findings during illness fails to correlate with the psychologic findings on follow-up. However, the presence of focal neurologic signs appears to be associated with higher performance IQs than verbal IQs (no instances of the opposite) and poorer visualmotor coordination.

The California group of arboviruses are now recognized as a significant cause of encephalitis in children. Fifty children with California encephalitis were seen at Columbus Children's Hospital between 1966 and 1970. The illness characteristically began abruptly with fever, lethargy, vomiting, and progressive encephalitic findings during the first two to four days and with recovery in seven to ten days. Focal neurologic findings were present in 20% and electroencephalograms revealed asymmetrical delta-wave activity in 40% of the children during the acute phase of the illness.

MUMPS meningoencephalitis is usually a benign self-limiting disease; its clinical features are fever, headache, nausea, vomiting, and meningeal signs. The clinical course is of short duration, and death or major neurological complications are rare.The patient with mumps meningoencephalitis described in this report is unusual because of the persistence of an elevated cerebrospinal fluid (CSF) protein level and pleocytosis.Report of a CaseAn 11-year-old boy was admitted to Columbus (Ohio) Children's Hospital on Aug 6, 1973. Five days prior to admission, earache, fever, vomiting, and ataxia had developed. The following day, his temperature rose to 40 C (104 F). His physician gave him an injection of penicillin, and ampicillin in a dosage of 500 mg orally every six hours was prescribed. In spite of antibiotic therapy, his illness progressed and he was admitted to the hospital because of confusion and visual hallucinations. At the time of admission, his temperature

Oral cefaclor is rapidly absorbed in patients with a shortened gastrointestinal tract (23 cm). A case is reported of a 27-month-old female child who had received oral cefaclor for five days in treatment of otitis media. The child had had a bowel resection at birth. She did not respond to oral therapy with cefaclor and was admitted to the hospital, where she received cefamandole intramuscularly. The patient recovered in five days.Further investigation using cefaclor with this patient demonstrated serum concentrations below the minimum inhibitory concentration of Hemophilus influenzae, pneumococcus, and many other organisms.When oral antibiotics are prescribed, it is necessary to monitor serum concentrations to ensure absorption.