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Herpes simplex encephalitis presenting with normal CSF analysis.

Rizwan Ahmed¹, Ismaa Ghazanfar Kiani, Faridullah Shah

¹Department of General Medicine, Federal Govt. Polyclinic, PGMI, Islamabad.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|October 31, 2013

Summary

This summary is machine-generated.

Herpes simplex meningo-encephalitis (HSE) can present with non-specific symptoms, mimicking other neurological infections. Early diagnosis and treatment with acyclovir are crucial for recovery, especially in regions with high endemic rates of other brain infections.

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Area of Science:

Neurology
Infectious Diseases

Background:

Herpes simplex meningo-encephalitis (HSE) is a severe neurological condition.
Differential diagnosis in regions with high prevalence of other central nervous system infections can be challenging.

Observation:

A 28-year-old female presented with headache, fever, altered sensorium, and right-sided hemiplegia.
Initial investigations for bacterial or tuberculous meningitis were negative.
MRI revealed left temporal lobe abnormalities without significant enhancement.

Findings:

Cerebrospinal fluid (CSF) analysis was normal, with negative Gram stain, Ziehl-Neelsen stain, and MTB PCR.
Herpes simplex virus type 1 (HSV-1) DNA was detected in the CSF via PCR.
The patient fully recovered after initiating acyclovir treatment.

Implications:

A high index of suspicion for HSE is necessary in Pakistan, where it may be overlooked.
Timely diagnosis and treatment of HSE are critical for favorable patient outcomes.
This case highlights the importance of considering viral encephalitis in the differential diagnosis of acute neurological presentations.