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Evolution of post-natal herpes simplex virus encephalitis to multicystic encephalopathy
Y Chang1, D Soffer, D S Horoupian
1Department of Pathology, Stanford University School of Medicine, CA 94305-5324.
Acta Neuropathologica
|January 1, 1990
Summary
Herpes simplex virus type 2 (HSV-2) can cause multicystic encephalopathy (MCE) in infants. Even without clear viral evidence at autopsy, HSV-2 infection should be considered in MCE cases.
Area of Science:
- Neurology
- Virology
- Pediatrics
Background:
- Herpes simplex virus type 2 (HSV-2) encephalitis is a serious condition in infants.
- Multicystic encephalopathy (MCE) is a severe neurological condition characterized by cystic lesions in the brain.
Observation:
- A 3-week-old infant presented with biopsy-proven HSV-2 encephalitis.
- The infant's condition deteriorated despite antiviral treatment, leading to death at 18 weeks.
- Post-mortem examination revealed extensive multicystic encephalopathy (MCE) in the cerebral hemispheres.
Findings:
- HSV-2 genome was detected in the initial biopsy but not in post-mortem brain tissue.
- Microscopic examination of post-mortem tissue showed no features of viral infection.
- The cystic lesions of MCE were randomly distributed and not confined to specific vascular territories.
Implications:
- HSV-2 infection is a potential cause of multicystic encephalopathy (MCE) in infants.
- The absence of detectable viral genome at autopsy does not rule out an infectious etiology for MCE.
- This case highlights the importance of considering viral causes even when histological evidence is limited.