Early diagnosis of herpes encephalitis saves lives: A case report

Emine PARLAK, Ayşe ERTÜRK, Leyla KARACA
1.521 230

Abstract


Herpes simplex virus (HSV) is the most important pathogen causing endemic encephalitis. HSV-1 is responsible for 90% of the cases which is the only treatable viral encephalitis. Clinically it is characterized by decreased level of consciousness, changes in personality, convulsions, and focal neurological deficits. Diagnosis of HSV encephalitis is made by detection of HSV DNA in the cerebrospinal fluid via polymerase chain reaction (PCR) method. The mortality rate in untreated HSV encephalitis is 50-70%. In this paper a patient diagnosed as Herpes simplex encephalitis according to positive PCR, clinic findings, radiological imaging and electroencephalogram (EEG). The patient was successfully treated for 21 days with acyclovir without any complication. This case report emphasizes the value of early diagnosis and treatment.


Keywords


Acyclovir; encephalitis; herpes simplex virus; personality change

Full Text:

35-38


References


Beckham, J.D., Solbrig, M.V., Tyler, K.L., 2012. Viral encephalitis and meningitis. In: Bradley’s Neurology In Clinical Practice. RB. Daroff, GM. Fenichel, J. Jankovic, J.C., Mazziotta., eds. Elsevier, Philadelphia, 6th ed. pp. 1231-1258.

Cingue, P., Cleator, G.M., Weber, T. Monteyne, P., Sindic, C.J., VanLoon, A.M., 1996. The role of laboratory investigation in the diagnosis and management of patients with suspected herpes encephalitis: A consensus report. J. Neurosurg. Pschiatr. 6, 339-345.

Cleator, G.M., Klapper, P.E., 2004. Herpes Simplex. In: Principles and practice of clinical virology fifth edition. A.J. Zuckerman, J.E. Banatuala, J.R. Pattison, P.D. Griffiths and B.D. Schoub, eds. John Wiley and Sons Ltd., 5th ed. pp. 27-51.

Corey, L., 2005. Herpes simplex virus. In: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. G.L. Mandell, J.E. Bennett, R. Dolin, eds. Elsevier, Philadelphia, 6th ed. pp. 1762-1780.

Ferrari, S., Toniolo, A., Monaco, S., Luciani, F., Cainelli, F., Baj, A., Temesgen, Z., Vento, S., 2009. Viral Encephalitis: Etiology, Clinical Features, Diagnosis and Management. Open Infect. Dis. J. 3, 1-12.

Kim, H.J., Jun, W.B., Lee, S.H., Rho, M.H.., 2001. CT and MR findings of anthrax meningoencephalitis: Report of two cases and review of the literature. Am. J Neuroradiol. 22, 1303-1305. Parlak et al.

Fig. T2 weighted MRI showing hyperintensity in right temporal lobe