Table 1.
Case reports (max. 4 homogenous patients) included in the review
| Author | Children (n) | Adults (n) | Immuno-suppressed (n) | Pathogen | Max. dose per day | Start of therapy (hospital day/day after symptom onset) | Duration of theray (days) | Mono- vs. add-on-therapy | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| Akcakaya et al. [32] | 1 | 0 | 0 | EV | 20 mg/kg | 11/101 | 5 | Mono | Good recovery |
| Barah [31] | 1 | 0 | 0 | hPV-B19 | ? | ?/40 | 5 | Add-on (steroids) | Full recovery |
| Borg et al. [44] | 0 | 1 | 0 | EBV | 400 mg/kg | ?/? | 5 | Add-on (aciclovir) | Full recovery |
| Caramello et al. [45] | 0 | 1 | 0 | JEV | 400 mg/kg | ?/? | 5 | Mono | Only slight deficits short term memory |
| Erol I [46] | 1 | 0 | 0 | hPV-B19 | 400 mg/kg | 11/21 | 5 | Add-on (steroids, acyclovir) | Clinical improvement (seizures) |
| Eyckmans et al. [47] | 0 | 1 | 1 | EV (Coxsackie-virus A16) | 400 mg/kg | 4/? | 5 | Add-on (aciclovir) | Marked improvement, intermitt confusion and language deficits |
| Fay AJ [48] | 1 | 0 | 0 | HHV-7 | ? | 1/3 | ? | Add-on (aciclovir, steroids, plasma exchange) | Clinical improvement |
| Garzo-Caldas et al. [49] | 0 | 1 | 1 | EV | 2 g/kg | ?/? | 1 (repeated bimonthly) | Add-on (methylprednisolone) | Dead |
| Geller et al. [50] | 1 | 0 | 1 | EV (Coxsackie-virus B4) | 400 mg/kg | 21/32 | 2 | Add-on (aciclovir) | Full recovery |
| Georgescu et al. [51] | 1 | 0 | 0 | EV | ? | ?/? | 10 | Add-on (aciclovir, steroids) | Slow but favourable recovery |
| Golomb et al. [52] | 0 | 1 | 0 | EEEV | 42 g | 5/? | 5 | Add-on (aciclovir, steroids) | Full recovery |
| Greco et al. [53] | 1 | 0 | 0 | hPV-B19 | 400 mg/kg | ?/3 | 5 | Add-on (dexamethasone) | Severe ataxia |
| Hartmann et al. [54] | 0 | 2 | 2 | SLEV | 400 mg/kg | 7/8; 13/20 | 5 | Add-on (INF alpha-2b) | 1 × full recovery; 1 × residual dysarthria |
| Hindo et al. [55] | 1 | 0 | 1 | WNV | 1 g/kg | 4/11 | 3 | Add-on (aciclovir, steroids;G-CSF); 1 × WNV-antibody-enriched IVIG | Dead |
| Hollander et al. [56] | 0 | 1 | 1 | WNV | ? | 7/21 | 1 | Add (aciclovir) | dead |
| Kimura [57] | 0 | 1 | 0 | NV | 4.2 g | 3/5 | 3 | Add-on (acyclovir, methylprednisolone) | Clinical improvement |
| Kleinschmidt-deMasters [58] | 0 | 4 | 4 | WNV | 1 g/kg | ?/? | 1 | Add-on (alpha-2b; ribavirin) | 1 × no residual symptoms, 1 × mild residual symptoms, 2 × severe residual symptoms |
| Kleiter et al. [59] | 0 | 1 | 0 | TBEV | 400 mg/kg | ?/20 | 5 | Mono | Clinical improvement with residual symptoms leading to early retirement |
| Lau et al. [60] | 0 | 1 | 1 | EBV | 68 g | ?/? | 2 | Add-on (ganciclovir) | Full recovery |
| Matsumoto et al. [61] | 0 | 2 | 0 | measles | 5 g; 2,5 g | 5/10; 5/11 | 3 | 1 × mono; 1 × add-on (aciclovir) | Full recovery |
| Miyagi et al. [62] | 0 | 1 | 1 | VZV | 400 mg/kg | ?/11 | 8 | Add-on (aciclovir, ganciclovir) | Vegetative state |
| Morjaria et al. [3] | 0 | 2 | 2 | WNV | ? |
?/?; 11/? |
?; 7 | Add-on (aciclovir); mono | Dead |
| Nakano et al. [63] | 1 | 0 | 0 | JEV | 5 g/d | ?/? | 3 | Add-on (aciclovir, methylprednisolone) | Full recovery |
| Nolan et al. [64] | 3 | 0 | 0 | EV (EV71) | 1 g/kg | 5 to 9/? | 2 | Add-on (pleconaril, steroids) | ? |
| Odessky et al. [65] | 1 | 0 | 0 | mumps | 30 ml | 1/5 | 5 | Mono | Full recovery |
| Padate et al. [66] | 0 | 1 | 1 | EV | 400 mg/kg | ?/? | > 4 | Add-on (aciclovir, ganciclovir) | Dead |
| Quartier et al. [67] | 1 | 1 | 2 | EV | ? | ?/? | ? | Add-on (pleconaril) | Improvement with residual deficits |
| Rhee et al. [68] | 0 | 1 | 1 | WNV | 400 mg/kg | 4/? | 2 | Add-on (ganciclovir) | No neurological deficit |
| Saquib et al. [69] | 0 | 1 | 1 | WNV | 1 g/kg | 2/7 | 1,5 | Add-on (aciclovir) | Full recovery |
| Schilthuizen et al. [70] | 0 | 1 | 1 | EV | 40 g | ?/? | 1/week, ongoing | Mono | Full recovery |
| Shaheen et al. [71] | 1 | 0 | 1 | EV | 500 mg/kg | ?/? | 1/week, ongoing | Add-on (aciclovir) | Significant neurological sequelae |
| Smudla et al. [72] | 0 | 1 | 1 | WNV | ? | ?/? | ? | Add-on (aciclovir) | Complete recovery |
| Suga et al. [73] | 1 | 0 | 0 | mumps | 1/kg | ?/? | 2 | Add-on (methylprednisolone) | Bedridden |
| Ueno et al. [74] | 0 | 1 | 1 | CMV | 5 g | ?/? | 3 (repeated monthly) | Add-on (aciclovir, ganciclovir) | Full recovery |
| Villace [75] | 0 | 1 | 0 | EBV | 32 g/d | ?/21 | 5 | Add-on (acyclovir, dexamethasone) | Clinical improvement |
| Winston et al. [76] | 0 | 4 | 4 | WNV | 500 mg/kg | ?/6; ?/2; ?/8; 1/1 | 5;4;6;13 | Add-on (aciclovir + INF-alpha 2b/INF-alpha2b (2x)/ribavirin) | Dead (2x)/full recovery (2x) |
| Xu [77] | 0 | 1 | 0 | CMV | 400 mg/kg | 28/? | 5 (repeated 3-weekly) | Add-on (ganciclovir/valganciclovir, prednisone) | Clinical improvement |
| Yango et al. [78] | 0 | 3 | 3 | WNV | 400 mg/kg | 6/10; 1/3; 2/6 | 3; 4; 4 | Add-on | Dead/discharge home/full recovery |
| Zaganas [79] | 0 | 1 | ? | CMV | ? | ?/? | ? | Add-on (ganciclovir, steroids) | Clinical improvement |
EV enterovirus, hPV-B19 human parvovirus B19, EBV Ebstein–Barr-virus, JEV Japanese encephalitis virus, HHV-7 human herpesvirus-7, EEEV eastern equine encephalitis, SLEV St Louis encephalitis virus, WNV West Nile virus, NV norovirus, TBEV tick-borne encephalitis virus, VZV varicella zoster virus, CMV cytomegaly virus