[A case of herpetic meningoencephalitis. Serological and imaging diagnosis]

The paper reports a case of HSVE observed in a 46-year-old patient with a negative anamnesis for previous HSV infection and with no objective signs of herpetic muco-cutaneous infection at time of hospitalisation. Due to the impossibility of carrying out bioptic and cultural tests, the diagnosis was based on the increased levels of specific anti-HSV1 antibodies in the liquor; these findings were compared to those found in serum, taking into account the increased antibody titres and in particular the ratio between the level of liquor and serum albumin and that of specific antibodies in both liquor and serum. The diagnostic importance of cerebral CT was confirmed by the early revelation of morphostructural alterations during the acute phase. RMN also allowed a more detailed imaging diagnosis to be made. From a therapeutic point of view, the paper confirms the value of acyclovir treatment.