Battlestar Galactica (2003- )

The Sci-Fi channel does its research when it comes to medical accuracy. Although the condition in the description below was "manufactured" to kill off Cylons, the facts are still there. This is an important topic in virology: Lymphocytic choriomeningitis virus.

Background:

Lymphocytic choriomeningitis virus (LCMV) is a single-stranded RNA virus, which belongs to the family Arenaviridae (so named because of its electron microscopic appearance, which resembles grains of sand). LCMV produces a febrile, self-limited, biphasic disease, called lymphocytic choriomeningitis (LCM), which often is complicated by aseptic meningitis. Asymptomatically infected (carrier state) rodents, which most commonly are house mice, domestic mice, and hamsters, serve as the reservoirs for human infection. LCMV most commonly is transmitted by inhalation of infected excreta. Contamination of scratches on the skin is an important route of infection in pet handlers and laboratory technicians.

Pathophysiology:

The initial viremia (phase 1) extensively seeds extra-CNS tissue. The secondary viremia (phase 2) infects the meninges and, less commonly, the cortical tissue. The leptomeninges are infiltrated mainly by lymphocytes and histiocytes, with few neutrophils. In encephalitis, the same type of inflammatory cells is observed in the perivascular Virchow-Robin spaces. LCMV is not cytotoxic. It appears that the host's immune response to the infected cells produces the various manifestations of this disease. Natural killer (NK) cells are first to respond. Cytotoxic T cells follow with their production of interferon. Additionally, LCMV can suppress the production of acetylcholine neuronal cells in cell culture.

LCM may affect the autonomic nervous system, various sensory modalities, and cranial nerves. Meningitis occasionally may become chronic and may lead to hydrocephalus. Other organs, especially the testes, heart, and joints, may be involved. Orchitis usually is unilateral. Cardiac involvement is typical of viral myocarditis. The metacarpal phalangeal joint and the proximal interphalangeal joint are the most common sites of arthritis caused by LCM. The objective swelling, redness, and pain resolve within a few weeks.

Epidemiology:

Only proven to occur in the continental USA and Europe, overall mortality has been shown to be less than 1%.

Clinical Features:

• A mild flu-like illness ranging to encephalitis.
• Contact history with rodents or lab workers.
• Phase 1: fever, headache, LN and a maculopapular rash.
• Settles after 3-5 days but the headache may return after 4 days.
• Immunosuppressed patients may present with:
• Altered mental state.
• Leucopenia.
• Thrombocytopenia.
• Hypoxia.
• Renal/liver dysfunction.
• Coagulopathy.
• Haemorrhagic fever.
• Usually there is complete recovery.

Differential Diagnosis:

*Cerebrospinal fluid

Treatment:

Pregnancy:

AMH