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A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation
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Herpes simplex virus type-1 meningoencephalitis showing disseminated cortical lesions

Kosuke Naito1, Takao Hashimoto, Shu-ichi Ikeda

  • 1Center for Neurological Diseases, Aizawa Hospital, Matsumoto. tamame@aurora.ocn.ne.jp

Internal Medicine (Tokyo, Japan)
|June 2, 2007
PubMed

Insights

Herpes simplex virus type 1 (HSV-1) can cause disseminated encephalitis, presenting as widespread small cortical lesions. Early diagnosis and treatment with acyclovir are crucial for patient recovery.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Meningoencephalitis is a severe inflammation of the brain and meninges.
  • Herpes simplex virus type 1 (HSV-1) is a common cause of sporadic, fatal encephalitis.

Observation:

  • A 41-year-old man presented with fever, headache, dysuria, convulsions, and neck stiffness.
  • Cerebrospinal fluid (CSF) analysis revealed pleocytosis.
  • Enzyme-linked immunosorbent assay (ELISA) showed a significant rise in HSV-1 specific IgG and IgM antibodies in CSF and serum.
  • Magnetic Resonance Imaging (MRI) revealed atypical disseminated cortical lesions, primarily in the gray matter, without massive hemispheric involvement.

Findings:

  • The patient's CSF neutralization test confirmed HSV-1 infection with a titer of x16.
  • The elevated antibody index for IgM (4.2) in CSF further supported intrathecal HSV-1 antibody production.
  • The MRI findings of disseminated cortical lesions were atypical for HSV encephalitis.

Implications:

  • This case highlights that disseminated encephalitis can be a manifestation of acute HSV-1 infection.
  • The findings underscore the importance of considering HSV-1 in cases of encephalitis with unusual imaging features.
  • Prompt diagnosis and treatment with acyclovir led to the patient's recovery, emphasizing the efficacy of antiviral therapy.

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