Related Experiment Video
Updated: May 28, 2026
08:20
Hippocampal Neuronal Cultures to Detect and Study New Pathogenic Antibodies Involved in Autoimmune Encephalitis
Published on: June 2, 2022
Chronic granulomatous herpes encephalitis: a rare entity posing a diagnostic challenge
Matthew A Adamo1, Lisa Abraham, Ian F Pollack
1Division of Neurosurgery, Albany Medical Center, Albany, New York, USA.
Journal of Neurosurgery. Pediatrics
|October 4, 2011
Summary
This case study highlights granulomatous herpes simplex encephalitis, a rare chronic form of HSV encephalitis. A patient with low Toll-like receptor 3 response experienced intractable seizures and worsening brain imaging.
Area of Science:
- Neurology
- Immunology
- Virology
Background:
- Herpes simplex virus (HSV) encephalitis is typically acute but can rarely become chronic or granulomatous.
- Antiviral immunity, particularly involving Toll-like receptors (TLRs), is implicated in herpesvirus susceptibility.
Observation:
- A 14-year-old girl with a history of treated HSV encephalitis presented with intractable seizures and progressive MRI abnormalities.
- The patient exhibited a diminished cytokine response to Toll-like receptor 3 (TLR3) stimulation.
Findings:
- The patient was diagnosed with granulomatous herpes simplex encephalitis.
- This rare condition was associated with a poor TLR3-mediated cytokine response.
Implications:
- This case underscores the potential for HSV encephalitis to manifest as a chronic granulomatous form.
- Understanding TLR3 pathway dysfunction may offer insights into managing rare, severe herpesvirus infections.
- Further research into TLRs and chronic herpesvirus pathogenesis is warranted.
Related Concept Videos
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:23Genital Herpes
Genital herpes is a sexually transmitted infection primarily caused by herpes simplex virus type 2 (HSV-2), though herpes simplex virus type 1 (HSV-1) is increasingly implicated in genital infections, particularly among younger populations. Transmission occurs mainly through sexual contact, with asymptomatic viral shedding serving as a major route of spread. This characteristic makes HSV-2 difficult to control at a population level, as individuals may unknowingly transmit the virus even in the...
01:25Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...