Herpes simplex meningo-encephalitis following cochlear implantation: a case study

Herpes simplex virus (HSV) is reported to be the most common cause of viral encephalitis. Although extremely rare, reactivation of the virus has been reported following central nervous system surgery. To the best of our knowledge, there is no report in the literature that describes HSV encephalitis following cochlear implantation.

We report a case of meningo-encephalitis occurring 17 days after cochlear implantation using an electro-acoustic stimulation device, with oerioperative steroid medication. Intensive anti-viral therapy was given and the patient recovered from the acute illness over 2 weeks. Agitation and anxiety followed the encephalitis and subsequent progress with the cochlear implant was slow. Twelve months after cochlear implantation this patient shows a gradual and steady progress with her hearing rehabilitation.

Cochlear implantation surgery was either coincidental or was the trigger factor for reactivation of the HSV. Surgeons must be vigilant to post-surgical meningism symptoms particularly if patients have a history of herpes infections.