Herpes simplex encephalitis after craniopharyngioma surgery

2008 ◽  
Vol 2 (5) ◽  
pp. 355-358 ◽  
Author(s):  
Ji-Woong Kwon ◽  
Byung-Kyu Cho ◽  
Eui Chong Kim ◽  
Kyu-Chang Wang ◽  
Seung-Ki Kim
Keyword(s):  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Ct Scanning ◽  
High Dose ◽  
C Reactive Protein ◽  
Chain Reaction ◽  
Reactive Protein ◽  
Serial Ct ◽  
Polymerase Chain ◽  
Simplex Virus

A 13-year-old girl exhibited rapid deterioration in mental status 15 days after surgery for craniopharyngioma. Serial CT scanning detected progression of a low-density lesion on the left frontotemporal lobe. The serum level of C-reactive protein was elevated and polymerase chain reaction identified herpes simplex virus DNA in the cerebrospinal fluid. Antiviral therapy with high-dose acyclovir (10 mg/kg 3 times daily) was begun. She recovered and could speak short sentences, but dysphasia and right hemiparesis remained. Early diagnosis and active treatment of herpes simplex encephalitis is essential for improving prognosis and saving lives.

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.

Relapse of Herpes Simplex Encephalitis in Children

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 891-894
Author(s):  
Hiroshi Kimura ◽  
Kosaburo Aso ◽  
Kiyotaka Kuzushima ◽  
Naoki Hanada ◽  
Motohiro Shibata ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Cerebrospinal Fluid ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Polymerase Chain Reaction Assay ◽  
Herpes Simplex Encephalitis ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Acyclovir Therapy ◽  
Simplex Virus

The polymerase chain reaction method was used to diagnose herpes simplex encephalitis in children. Initial samples of cerebrospinal fluid from 15 patients with herpes simplex encephalitis were all positive for the herpes simplex virus DNA by polymerase chain reaction assay. In terms of early diagnosis, polymerase chain reaction assay became positive significantly earlier than the detection of intrathecally produced anti-herpes simplex virus antibody using the enzyme-linked immunosorbent assay (4.4 vs 8.9 days after onset; P < .01). Serial examinations showed that the presence of virus DNA in cerebrospinal fluid continued for 3 to 18 days after the neurologic onset (mean 10.1 days). Four of the 15 patients had a relapse of encephalitis after completing acyclovir therapy. The mean duration of initial acyclovir therapy in the recurrent group was significantly shorter than that in the nonrecurrent group. In recurring cases, herpes simplex virus DNA reappeared temporarily in the cerebrospinal fluid of two patients. These results show that polymerase chain reaction assay is a useful diagnostic tool for the early and noninvasive diagnosis of herpes simplex encephalitis in children. Results also suggest that a comparatively short duration of acyclovir therapy may be related to a relapse of herpes simplex encephalitis in some children.

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