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Herpes simplex encephalitis

Overview

Herpes simplex encephalitis refers to a brain parenchyma infection caused due to herpes simplex viral infection. It leads to inflammation and swelling of brain parenchyma and covering of the brain (meninges).

Herpes simplex virus infection

  • Genetic defects in the Toll-like receptor (TLR3)-interferon (IFN) and IFN-responsive pathways
  • Chemotherapy and chronic alcoholism
  • History of substance abuse
  • A past medical history of sinusitis or psychotic disorders

  • Fever
  • Headache
  • Altered sensorium- confusion, disorientation, coma
  • Neck stiffness
  • Seizures
  • Weakness, nausea, vomiting
  • If not treated timely and adequately, may prove to be life threatening

Neurologist

  • CSF examination to determine pleocytosis
  • MRI brain to determine contrast enhancement in temporal areas, or vasculitic infarcts
  • EEG to check periodic lateralized discharges.
  • Blood tests for HIV antibodies

  • Antiviral therapy (acyclovir)
  • Supportive care- management of seizures, fluid replenishment, hydration and calory supplementation
  • ICU care may be required

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