Kaposi’s varicelliform eruption in herpes simplex encephalitis (original) (raw)
Related papers
Atypical herpes simplex encephalitis: Clinical, virologic, and neuropathologic evaluation
Neurology, 1992
Article abstract-An atypical form of herpes simplex encephalitis produced by HSV-1 documented in the present article demonstrates that (1) prominent EEG abnormality may correlate with subtle increase in signal intensity on MRI; (2) the disease may start with prominent involvement of the cingulate gyri; and (3) viral infection of the brainstem may cause early onset of severe neurologic dysfunction and coma.
Subacute presentation of herpes simplex virus-1 encephalitis: A rare case report
Journal of Medical Society, 2018
Herpes simplex virus 1 is a prevalent neurotropic pathogen that infects and establishes latency in peripheral sensory neurons. It can migrate into the central nervous system and cause encephalitis. e association between herpes simplex virus encephalitis and cerebral venous thrombosis is rare, with a very limited number of case reports described in the literature, despite the recognized thrombogenic effects of the virus. A 44-year-old man was brought to the emergency department with generalized tonic-clonic seizures requiring sedation and ventilation to control it. Initial brain computed tomography revealed cortical and subcortical edema on the left frontal lobe, and a subsequent contrast-enhanced exam showed absence of venous flow over the anterior half of the superior sagittal sinus. Cerebrospinal fluid polymerase chain reaction was positive for herpes simplex virus type 1, and the patient was started on acyclovir and anticoagulation, with clinical improvement. Acyclovir administration was maintained for 14 days and oral anticoagulation for one year, with no recurrence of thrombotic events or other complications. A well-timed treatment has a validated prognostic impact on herpes simplex encephalitis, making early recognition of its clinical aspects of main importance.
Case Report HERPES SIMPLEX ENCEPHALITIS AS A FATAL DISEASE :
disease with high mortality if misdiagnosed or untreated. It can presents with acute features such as a headache, fever, seizures and confusion. It sometimes suspected as meningitis before MRI, and then the patient loses a chance for survival because of late diagnosis, and late treatment as a result. The combination of clinical history and examination, brain computed tomography scan, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis have been used to establish the diagnosis. Here, we are presenting a rare case of HSE presenting as confusion, fever and disorientation with nonspecific CSF analysis, then seizures, and typical MRI findings consistent with HSE and CSF polymerase chain reaction positive for herpes simplex virus-1 DNA. Unfortunately the diagnosis was late, and even with acyclovir the patient died after 2 weeks. Herpes simplex encephalitis must be suspected in a patient with disoriented with coma or seizures, and MRI gives the best view for direction the management.
Acute Cerebellitis Caused by Herpes Simplex Virus Type 1
Clinical Infectious Diseases, 2003
Cerebellar disorders due to herpes simplex virus (HSV) infection are rare and always associated with herpes simplex encephalitis. We report 2 cases of severe primary acute cerebellitis caused by HSV type 1 that were identified by nested polymerase chain reaction performed on cerebrospinal fluid samples. Herpes simplex virus type 1 (HSV-1) is one of the most common causes of sporadic viral encephalitis in adults. Herpes simplex encephalitis (HSE) may be a consequence of both primary and recurrent HSV infections, and it is characterized by focal necrosis of the medial temporal and inferior frontal lobes and, occasionally, of the insular cortex and cingulate gyrus [1, 2]. Such lesions are unusual in other brain areas, and, to our knowledge, isolated cerebellar involvement has never been reported. Herein we describe 2 cases of HSV-1 acute cerebellitis in which HSV-1 DNA was detected in the CSF samples by nested PCR. Case reports. Patient 1, a stammering 24-year-old woman who had experienced headache, dysarthria, ataxia, vomiting, and moderate fever for 7 days, was referred to our hospital because of a gradual worsening of her symptoms. At admission, neurologic examination revealed normal cognition, ataxia, dysarthria with exacerbation of her dysphemia, dysmetria on the entire left side of the body, and nystagmus. Reflexes were brisk, and there was no evidence of meningeal signs. Blood examination was notable for a mild increase in WBC count (11,790 cells/mm 3 [78% neutrophils and 16% lymphocytes]) and an erythrocyte sedimentation rate of 56 mm/h. Results of liver and
A Study on Herpes Simplex Encephalitis in 18 Children, Including 3 Relapses
The Open Pediatric Medicine Journal, 2009
Background: Herpes Simplex Virus (HSV) is the most common cause of acute sporadic focal encephalitis. Early Diagnosis is, therefore, crucial for predicting outcome. Improved laboratory technology and improved neuroimaging accessibility have enhanced our ability to diagnose this condition.
A Probable Case of Herpes simplex Encephalitis despite Negative PCR Findings Findings
Infection, 2001
A 54-year-old woman was admitted to the hospital suffering from fever and personality changes. Laboratory examination of her cerebrospinal fluid (CSF) showed 270 mononuclear cells, 30 polynuclear cells and a clinically low number of erythrocytes/mm 3. Empirical clinical findings from this case suggested treatment with acyclovir. Magnetic resonance imaging (MRI) showed bilateral temporal hyperintense signals in T2-weighted images. PCR with specific primer for herpes simplex virus type 1 (HSV-1) and HSV-2 were negative. There was no elevation of oligoclonal antibodies specific to HSV in CSF after 2 weeks. Although we did not prove the presence of the agent microbiologically at the clinical onset of the disease, the MRI and electroencephalogram (EEG) findings, erythrocytes in CSF and the dramatic response to acyclovir therapy are suggestive of a diagnosis of herpes simplex encephalitis (HSE).
An unusual presentation of herpes simplex virus encephalitis
Case reports in medicine, 2012
We present a case of a 65-year-old man with an acute alteration in mental state that was initially diagnosed as a functional psychiatric condition. After extensive workup, herpes simplex virus type 1 (HSV-1) was detected in the patient's cerebrospinal fluid (CSF) by polymerase chain reaction (PCR), and he responded rapidly to treatment with acyclovir. The case illustrates the importance of actively excluding organic causes in such patients, the need to have a low threshold of suspicion for HSV encephalitis, and the central role of CSF PCR testing for the diagnosis of HSV encephalitis, even in the absence of CSF biochemical abnormalities.
Journal of Tropical Pediatrics, 2005
Acute hemorrhagic leukoencephalitis (AHL) is a rare and usually fatal disorder characterized by an acute onset of neurological abnormalities. It may occur in association with a viral illness or vaccination. Radiology and brain biopsy are essential for the diagnosis. We present a case of AHL mimicking or manifesting as intracerebral hemorrhage associated with herpes simplex virus. A 3-year-old boy was admitted to our hospital with cerebral hemorrhage. The findings of cerebrospinal fluid, MRI and electroencephalogram indicated acute hemorrhagic leukoencephalitis associated with herpes simplex virus involving the left parietal cortex (hemorrhage) and the right temporal lobe (encephalitis). The patient received intravenous dexamethasone (1.5 mg/kg/24 h divided q6 (six times a day) for 5 days, tapered slowly to discontinuation over the next 5 days) and aciclovir (15 mg/kg/every 6 h for 14 days). His clinical condition markedly improved, and after 3 weeks he was discharged from the hospital with moderate right hemiparesis. Mild hemiparesis with normal psychometric testing was determined when he was checked 6 months later. AHL remains misdiagnosed as viral encephalitis because it produces different protean clinical forms. Pediatric patients admitted with cerebral hemorrhage and infarct should be evaluated for presence of hemorrhagic encephalitis-causing agents, especially for herpes simplex. Since, as in our case, treatment with corticosteroid and acyclovir markedly improves conditions of herpes simplex-caused AHL, we suggest that early diagnosis and treatment is of importance for the prognosis.
SAGE Open Medical Case Reports
Headaches in children are a common, but unspecific symptom that can have many underlying causes, ranging from unspecific tension headache through migraine and up to encephalitis and intracranial hypertension. We present the case of a 14-year-old boy who presented to our emergency department with headache, nausea as well as vomiting and developed seizures later on. The initial diagnosis was complicated by a magnetic resonance imaging which did not show any signs of inflammation, but was of limited informative value due to orthodontic appliances. Despite the unremarkable imaging, prophylactic antiviral and antibiotic treatment was started after lumbar puncture. Herpes simplex virus as well as human herpes virus 7 were confirmed in the cerebrospinal fluid. Although both viruses are ubiquitous, severe infections are a rare complication. Immunodeficiency syndromes are predisposing factors for serious complications and genetic analysis of UNC93B and TLR-3 might be helpful for decision-mak...