Progressive Rubella Panencephalitis
Most viruses that infect humans can affect both adults and children and are discussed elsewhere in THE MANUAL. Viruses with specific effects on neonates are discussed in Infections in Neonates. This chapter covers viral infections that are typically acquired during childhood (although many may also affect adults).
Some children with congenital rubella syndrome (eg, with deafness, cataracts, microcephaly, and intellectual disability) develop neurologic deficits in early adolescence.
The diagnosis of progressive rubella panencephalitis is considered when a child with congenital rubella develops progressive spasticity, ataxia, mental deterioration, and seizures. Testing involves at least CSF examination and serologic testing. CSF total protein and globulin and rubella antibody titers in CSF and serum are elevated.
CT may show ventricular enlargement due to cerebellar atrophy and white matter disease.
Brain biopsy may be necessary to exclude other causes of encephalitis or encephalopathy. Rubella virus usually cannot be recovered by viral culture or immunohistologic testing.