Herpes simplex virus encephalitis (HSVE) is an acute or subacute illness associated with focal or global cerebral dysfunction. It is caused by herpes simplex viruses belonging to either type 1(HSV-1) or type 2(HSV-2). Most of HSVE is caused by HSV-1. The most common manifestations include encephalopathy, fever, seizures, headaches, and focal neurological deficits.
49-year-old patient who has diabetes mellitus type 1, first presented with a fever, followed by a generalized epileptic seizure. In the Emergency Room a lumbar puncture was performed, and HSV-1 was detected in the cerebrospinal fluid. MR of the brain concluded that the changes correspond to the changes within HSV-1 encephalitis with a smaller area of hemorrhage. The patient was prescribed with acyclovir 3×10 mg/kg i.v. for three weeks. After antiviral therapy and glycemic control, the patient was discharged with antiepileptic, antihypertensive, antiulcer and antidiabetic drugs and indication to do a control EEG and infectologist exam with laboratory findings.
HSVE has high morbidity and mortality, and the treatment of choice is acyclovir therapy.
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