Orbital Lymphatic-Venous Malformation Accompanied by an Intraocular Vascular Malformation: A Rare Case Study

Lymphatic-venous malformations (LVMs) are development defects that result in abnormal connections between the lymphatic and venous systems. The authors describe a 7-weeks-old female infant who presented with a right orbital LVM extending to the ipsilateral cheek and subconjunctiva of the right eye, intracranial developmental venous anomalies in the right cerebellum, and a significant right eye intraocular retinal vascular malformation. Since orbital LVM is usually diagnosed in infancy or childhood, pediatric ophthalmologists should actively look for intraocular vascular malformations as such findings can poorly affect a patient’s vision

Increase Human Metapneumovirus Mediated Morbidity following Pandemic Influenza Infection

Human metapneumovirus (hMPV) is a recently discovered respiratory pathogen, infecting mainly young children. The infected patients suffer from influenza like symptoms (ILS). In Israel the virus is mainly circulating in February to March. Here we report on an increased rate of hMPV infection in the winter season of 2009–10. The 2009–10 infection had several unique characteristics when compared to previous seasons; it started around January and a large number of infants were infected by the virus. Genetic analysis based on the viral L and F genes of hMPV showed that only subtypes A2 and B2 circulated in Israel. Additionally, we have identified a novel variant of hMPV within subgroup A2b, which subdivide it into A2b1 and A2b2. Finally, we showed that the hMPV infection was detected in the country soon after the infection with the pandemic influenza virus had declined, that infection with the pandemic influenza virus was dominant and that it interfered with the infection of other respiratory viruses. Thus, we suggest that the unusual increase in hMPV infection observed in 2009–10 was due to the appearance of the pandemic influenza virus in the winter season prior to 2009–10

Epidemiological changes of respiratory syncytial virus (RSV) infections in Israel.

RSV is the leading cause of lower respiratory-tract infections in infants and therefore demands in-depth epidemiological characterization. We investigated here the distribution of RSV types in Israel between the years 2005-2012. Clinical samples were collected from 11,018 patients hospitalized due to respiratory illnesses and were evaluated for the presence of various respiratory viruses, including RSV A and RSV B. Until 2008, each year was characterized by the presence of one dominant type of RSV. However, from 2008, both RSV A and B types were detected at significant levels, particularly among infants aged 0-2 years. Furthermore, significant changes in the RSV A and RSV B subtypes circulating in Israel since 2008 were observed. Finally, we demonstrate that, irrespectively of the changes observed in RSV epidemiology, when the pandemic H1N1pdm09 influenza virus appeared in 2009, RSV infections were delayed and were detected when infection with H1N1pdm09 had declined

A large number of infants were infected with hMPV in 2009–10.

<p>The figure shows the percentages of the age distribution of the hMPV positive cases diagnosed at the Central Virology Laboratory between November 2007 and May 2010.</p

Respiratory viruses circulating in the country during the study period.

<p>The figure depicts percentages of patients hospitalized due to influenza-like symptoms that were found positive for infection with either influenza (A and B), with pandemic influenza (H1N1s) and hMPV between 2007–2010.</p

The hMPV infection in 2009–10 is observed early than usual.

<p>Precent of hMPV infected patients throughout the year. The figure shows themonthly distribution of hMPV positive cases diagnosed at the Central Virology Laboratory between November 2007 and May 2010.</p

Percent of Hospitalized hMPV patients in Israel.

<p>Percent of patients positive for hMPV infections out of patients diagnosed for respiratory virus infections. The patients were hospitalized in the Sheba Medical Center, Israel, and three winter seasons 2007–10 are presented.</p

Identification of new hMPV subtype.

<p>The figure shoe a phylogenetic tree that was constructed based on the nucleotide sequences (111 bp) of the Fusion gene (F protein).</p