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A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation
12:22

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Herpes simplex virus central nervous system relapse during treatment of infantile spasms with corticotropin

Joshua L Bonkowsky1, Francis M Filloux, Carrie L Byington

  • 1Division of Pediatric Neurology, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. joshua.bonkowsky@hsc.utah.edu

Pediatrics
|April 12, 2006
PubMed

Insights

A corticotropin treatment for infantile spasms in an infant with herpes simplex virus (HSV) encephalitis led to recurrent HSV reactivation. Concurrent acyclovir or avoiding corticotropin in HSV patients is recommended.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Herpes simplex virus (HSV) encephalitis is a severe neurological infection in infants.
  • Acyclovir is the standard treatment for HSV encephalitis.
  • Infantile spasms are a type of epilepsy that can occur in infants.

Observation:

  • An infant with HSV encephalitis experienced severe brain damage despite acyclovir treatment.
  • The infant later developed infantile spasms and was treated with corticotropin.
  • Following corticotropin treatment, the infant showed signs of recurrent HSV encephalitis with new brain lesions.

Findings:

  • Corticotropin treatment may have caused immunosuppression, leading to HSV reactivation.
  • Recurrent HSV encephalitis occurred despite previous treatment and despite new brain lesions.

Implications:

  • Corticotropin may be relatively contraindicated in patients with a history of HSV infection.
  • Concurrent intravenous acyclovir administration should be considered during corticotropin treatment in such patients.
  • This case highlights the potential risks of immunosuppressive therapy in patients with a history of viral encephalitis.

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