Relapse of herpes encephalitis induced by temozolomide-based chemoradiation in a patient with malignant glioma

2013 ◽  
Vol 118 (2) ◽  
pp. 258-263 ◽  
Author(s):  
Masaki Okada ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Nobuyuki Kawai ◽  
Takashi Tamiya
Keyword(s):  
Herpes Simplex ◽  
Malignant Glioma ◽  
Antiviral Therapy ◽  
Herpes Simplex Encephalitis ◽  
Viral Reactivation ◽  
Herpes Encephalitis ◽  
Antitumor Therapy ◽  
Careful Observation ◽  
History Of

The authors report on a case of concurrent herpes simplex encephalitis (HSE) and malignant glioma. The co-occurrence of HSE and malignant glioma is very rare, but it can occur during glioma treatment. Both radiotherapy and chemoradiation with temozolomide can induce viral reactivation, leading to HSE relapse. Careful observation for HSE is necessary when administering chemoradiation to patients with a history of HSE. Antiviral therapy for HSE must be initiated immediately, and the chemoradiation for glioma should be stopped; however, it is not clear what antitumor therapy is optimal when HSE co-occurs during the treatment of glioma.

Chronic granulomatous herpes encephalitis: a rare entity posing a diagnostic challenge

2011 ◽  
Vol 8 (4) ◽  
pp. 402-406 ◽  
Author(s):  
Matthew A. Adamo ◽  
Lisa Abraham ◽  
Ian F. Pollack
Keyword(s):  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Disease Process ◽  
Toll Like Receptor ◽  
Herpes Encephalitis ◽  
Diagnostic Challenge ◽  
Intractable Seizures ◽  
History Of ◽  
Simplex Virus ◽  
Chronic Disease State

Herpesviruses can cause an acute, subacute, or chronic disease state in both immunocompetent and immunocompromised individuals. Herpes simplex virus (HSV) encephalitis is most often an acute monophasic disease process. Rarely, however, it may progress to a chronic state, and more rarely still to a granulomatous encephalitis. Prior studies have suggested that antiviral immunity with Toll-like receptors determines susceptibility to herpesviruses. The authors report the case of a 14-year-old girl with a remote history of treated HSV encephalitis, who had intractable seizures and worsening MR imaging changes that were concerning for either a neoplastic or an inflammatory process. She was found to have granulomatous herpes simplex encephalitis and had a low cytokine response to Toll-like receptor 3 stimulation.

scholarly journals Herpes simplex reactivation following neurosurgery: case report and review of the literature

2019 ◽  
Vol 47 (2) ◽  
pp. E9 ◽  
Author(s):  
Diane C. McLaughlin ◽  
Rebecca L. Achey ◽  
Robert Geertman ◽  
Jonah Grossman
Keyword(s):  
Herpes Simplex ◽  
Antiviral Therapy ◽  
Viral Encephalitis ◽  
Herpes Simplex Encephalitis ◽  
Viral Reactivation ◽  
High Dose ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Direct Nerve ◽  
Simplex Virus

Herpes simplex encephalitis is a common viral encephalitis associated with significant morbidity and mortality if not diagnosed and treated early. Neurosurgery may be an impetus for viral reactivation, either from direct nerve manipulation or high-dose steroids often administered during cases. The authors present the 40th known case of herpes simplex virus (HSV) encephalitis following neurosurgical intervention and review the previously reported cases. In their review, the authors observed positive HSV polymerase chain reaction (PCR), which had initially been negative in several cases. In cases in which there is high suspicion of HSV, it may be prudent to continue antiviral therapy and retest CSF for HSV PCR. Antiviral therapy significantly reduces mortality associated with HSV encephalitis.

scholarly journals Recurrence of herpes simplex encephalitis associated with temozolomide chemoradiation for malignant glioma: a case report and review of the literature

2014 ◽  
Vol 2014 (1) ◽  
pp. 1-4 ◽  
Author(s):  
M. P. Christman ◽  
S. E. Turbett ◽  
S. Sengupta ◽  
K. U. Bakhadirov ◽  
C. A. Williamson ◽  
...  
Keyword(s):  
Case Report ◽  
Herpes Simplex ◽  
Malignant Glioma ◽  
Herpes Simplex Encephalitis ◽  
Review Of The Literature

Herpes Simplex Encephalitis Occurring After Chemotherapy, Surgery, and Stereotactic Radiotherapy for Medulloblastoma

2000 ◽  
Vol 124 (12) ◽  
pp. 1809-1812
Author(s):  
S. Molloy ◽  
D. Allcutt ◽  
P. Brennan ◽  
M. A. Farrell ◽  
R. Perryman ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Surgical Removal ◽  
Formalin Fixed Paraffin ◽  
Recurrent Herpes ◽  
Formalin Fixed Paraffin Embedded ◽  
History Of ◽  
Cerebellar Medulloblastoma ◽  
Simplex Virus ◽  
Inflammatory Changes

Abstract Reactivation of latent herpes simplex virus (HSV) in the trigeminal ganglion most commonly gives rise to recurrent herpes labialis and rarely to herpes simplex encephalitis. The mechanisms underlying reactivation of latent trigeminal HSV are complex. Here we report the case history of a 25-year-old woman who developed a fatal, bilateral necrotizing destructive temporal lobe lesion following surgical removal of a cerebellar medulloblastoma and combined radiotherapy and chemotherapy for recurrent tumor. Neuropathologic examination of the brain revealed minimal inflammatory changes, but immunohistochemistry was positive for HSV protein, and HSV deoxyribonucleic acid (DNA) was recovered from formalin-fixed paraffin-embedded brain tissue. The temporal proximity of the surgery, chemotherapy, and radiotherapy to the onset of disease suggests that these factors may have acted as triggers that precipitated conversion of latent HSV to overt HSV.

Herpes encephalitis and hepatitis in pregnancy: A case report and literature review

2020 ◽  
pp. 1753495X2097803
Author(s):  
Claire M McCarthy ◽  
Caroline Conlon ◽  
Maria Kennelly ◽  
Richard Drew ◽  
Stephen Stewart ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Male Infant ◽  
Herpes Encephalitis ◽  
Intravenous Acyclovir ◽  
Simplex Virus ◽  
Herpes Simplex Virus 2 ◽  
Elevated Transaminases ◽  
Work Up ◽  
In Pregnancy

We present the case of a healthy nulliparous woman who presented with persistent fever, proteinuria and elevated transaminases at 33 weeks’ gestation. Following initial treatment for suspected chorioamnionitis and potential pre-eclampsia, she had a caesarean section delivering a healthy male infant. However, on her third post-operative day, she developed neurological symptoms and accompanying severe sepsis, necessitating inotropic support and transfer to a higher level of care. A comprehensive work-up revealed Herpes Simplex Virus-2 (HSV-2) in serum and cerebrospinal fluid. Abdominal imaging was suggestive of accompanying hepatitis with micro-abscesses. This lady recovered well following intravenous acyclovir for 14 days. Her infant was not affected and was discharged home with his mother. Herpes simplex encephalitis and hepatitis associated with HSV-2 have been described three times previously in pregnancy. We delineate the diagnostic challenges that rare conditions such as this pose and emphasise the importance of multi-disciplinary care in managing complicated medical conditions in pregnancy.

scholarly journals Herpes Encephalitis Masquerading as Tumor

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Tasneem Peeraully ◽  
Joseph C. Landolfi
Keyword(s):  
Herpes Simplex ◽  
Temporal Lobe ◽  
Herpes Simplex Encephalitis ◽  
Neoplastic Disease ◽  
Low Grade ◽  
Left Temporal Lobe ◽  
Herpes Encephalitis ◽  
Mri Findings ◽  
Left Frontal Lobe ◽  
Meningeal Enhancement

A 54 year old lady presented with lethargy and 15 kg weight loss over the past year. CT scan of the head revealed left temporal lobe hypodensity with a discrete area of hemorrhage within the left mesial temporal lobe. Due to concerns about impending central herniation, lumbar puncture was not performed. MRI of the brain showed a large lesion of the left temporal lobe, extending to the left frontal lobe, and very patchy meningeal enhancement. There was a noncontiguous lesion of the right insula. A differential diagnosis of herpes simplex encephalitis (HSE) and multifocal infiltrative glioma was entertained. MR spectroscopy demonstrated an increased choline peak at the level of the medial left temporal lobe and MR perfusion demonstrated patchy areas of hyperperfusion within the left anterior temporal lobe, both suggestive of neoplastic disease. Following open brain biopsy, pathology revealed herpes simplex virus (HSV) positive nuclei in the cortex and subcortical white matter. As both herpes simplex encephalitis and low-grade glioma demontrate MRI findings of hypointensity on T1 images and hyperintensity on T2 images, the diagnosis of herpes encephalitis can be clouded by confounding factors, especially when cerebrospinal fluid (CSF) cannot be obtained.

scholarly journals Neurosyphilis versus Herpes Encephalitis in a Patient with Confusion, Memory Loss, and T2-Weighted Mesiotemporal Hyperintensity

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Elisa Vedes ◽  
Ana Filipa Geraldo ◽  
Rita Rodrigues ◽  
Sofia Reimão ◽  
Alice Ribeiro ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Memory Loss ◽  
Herpes Encephalitis ◽  
Acute Confusion

Acute confusion and memory loss associated with asymmetrical mesiotemporal hyperintensity on T2-weighted MRI are characteristic of herpes encephalitis. The authors report the case of a patient with these symptoms and MRI presentation who had neurosyphilis. Recently clinical and imaging patterns usually associated with herpes simplex encephalitis have been seen in patients with neurosyphilis. Because syphilis is “The Great Pretender” not only clinically but also in imaging and because its numbers are rising, it must be sought as a differential diagnosis.

Cessation of antiviral therapy for herpes simplex encephalitis

1994 ◽  
Vol 124 (3) ◽  
pp. 490 ◽  
Author(s):  
Kazunari Kaneko ◽  
Haruko Watanabe ◽  
Mitsuru Hikita ◽  
Akifumi Tokita ◽  
Keijiro Yabuta
Keyword(s):  
Herpes Simplex ◽  
Antiviral Therapy ◽  
Herpes Simplex Encephalitis
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