SUBACUTE SCLEROSING PANENCEPHALITIS IN AN INFANT - DIAGNOSTIC ROLE OFVIRAL GENOME ANALYSIS

Subacute sclerosing panencephalitis (SSPE) is related to ''defective'' measles virus or vaccination, though an association with parainfluenz a viruses has, been reported. SSPE is characterized by a slow, erratic course and elevated cerebrospinal fluid measles titers. An immunocomp etent, vaccinated infant, with onset of symptoms in parainfluenza viru s season and a catastrophic course is described. Cerebrospinal fluid t iters were negative, but postmortem brain had typical SSPE lesions. Pa tient brain-derived RNA, subjected to reverse transcription followed, by polymerase chain reaction yielded polymerase chain reaction product s with measles virus but not parainfluenza virus genes. The sequenced fragment revealed multiple mutations, typical for SSPE. SSPE can thus present in infants, with short latency and no cerebrospinal fluid anti bodies. Viral genomic analysis may be diagnostic, permitting early the rapy.