It is never too late – HSV1-induced herepetic encephalitis


Authors: E. Dická 1;  Z. Pavlovičová 2;  Ľ. Podracká 1
Authors‘ workplace: Detská klinika LFUK a NÚDCH, Bratislava, Slovensko 1;  Rádiodiagnostické oddelenie NÚDCH, Bratislava, Slovensko 2
Published in: Čes-slov Pediat 2020; 75 (1): 34-39.
Category: Case Report

Overview

Herpetic encephalitis is the most prevalent sporadic fatal encephalitis in the world. The disease affects all age groups. The gold standard of diagnosis is the investigation of viral load in cerebrospinal fluid and the magnetic resonance imaging of the brain. Intravenous treatment with acyclovir is initiated immediately upon suspicion of herpes encephalitis. The recommended treatment duration is 21 days. Prior to therapy discontinuation, repeated lumbar punctures are recommended to confirm negative viral load by polymerase chain reaction.

In the article we demonstrate two case reports of herpetic encephalitis with different clinical course and prognosis.

Keywords:

herpetic encephalitis – lumbar puncture – acyclovir treatment


Sources

1. Tunkel AR, Glaser CA, Bloch KC, et al. The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2008; 47: 303–327.

2. Sedláček D, Štruncová V, Pizingerová K, et al. Herpetická encefalitida. Pediatr praxi 2004; 7: 226–230.

3. Opavský R, Herzig R, Kaňovský P. Herpetické infekce centrální nervové soustavy. Neurol praxi 2008; 9 (2): 87–90.

4. Tyler KL. Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret’s. Herpes 2004; 11 (2): 57–64.

5. Hatipoglu HG, Sakman B, Yuksel E. Magnetic resonance and diffusion-weighted imaging findings of herpes simplex encephalitis. Herpes 2008; 15: 13–17.

6. Ito Y, Kimura H, Yabuta Y, et al. Exacerbation of herpes simplex encephalitis after successful treatment with acyklovir. Clin Infect Dis 2000; 30: 185–187.

7. Salih M, El Khashab H, Hassan H, et al. A Study on herpes simplex encephalitis in 18 children, including 3 relapses. Open Pediatr Med J 2009; 3: 48–57.

8. Britton PN, Dale RC, Booy R, et al. Acute encephalitis in children: Progress and priorities from an Australasian perspective. J Paediatr Child Health 2015; 51: 147–158.

9. Taskin BD, Tanji K, Feldstein NA, et al. Epilepsy surgery for epileptic encephalopathy as a sequela of herpes simplex encephalitis: case report. J Neurosurg Pediatr 2017; 20 (1): 56–63.

10. Basak RB, Malpani V, Kakish K, et al. Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy. Indian J Dermatol 2011; 56 (6): 749–751.

11. Růžek D, Piskunova N, Žampachová E. High variability in viral load in cerebrospinal fluid from patients with herpes simplex and varicella-zoster infections of the central nervous system. Clin Microbiol Infect 2007; 13: 1217–1219.

12. Gong T, Bingaman W, Danziger-Isakov L, et al. Herpes simplex virus reactivation after subtotal hemispherectomy in a pediatric patient. Pediatr Infect Dis J 2010; 29 (12): 1148–1150.

13. Kendrick JG, Ensom MHH, Steer A, et al. Standard-dose versus high-dose acyclovir in children treated empirically for encephalitis: A retrospective cohort study of its use and safety. Pediatr Drugs 2014; 16 (3): 229–234.

14. Ruderfer D, Krilov LR. Herpes simplex viruses 1 and 2. Pediatr Rev 2015; 36 (2): 86–90.

15. Sköldenberg B, Aurelius E, Hjalmarsson A, et al. Incidence and pathogenesis of clinical relapse after herpes simplex encephalitis in adults. J Neurol 2006; 253 (2): 163–170.

16. Martinez-Torres F, Menon S, Pritsch M, et al. Protocol for German trial of Acyclovir and corticosteroids in Herpes-simplex-virus-encephalitis (GACHE): a multicenter, multinational, randomized, double-blind, placebo-controlled German, Austrian and Dutch trial [ISRCTN45122933]. BMC Neurol 2008; 8: 40.

17. Roháčová H. Infekce nervového systému vyvolané herpetickými viry. Med pro praxi 2008; 5 (3): 117–118.

Labels
Neonatology Paediatrics General practitioner for children and adolescents
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account