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Updated: Mar 13, 2026
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A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation
Published on: April 2, 2012
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Acyclovir resistance in herpes simplex virus type I encephalitis: a case report.
M Bergmann1, R Beer1, M Kofler1
1Department of Neurology, Neurocritical Care Unit, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Journal of Neurovirology
|October 28, 2016
Summary
Acyclovir resistance in herpes simplex virus type I encephalitis is rare, especially in immunocompetent patients. This case highlights the importance of considering resistance when treatment fails, even in previously healthy individuals.
Area of Science:
- Neurovirology
- Infectious Diseases
Background:
- Herpes simplex virus (HSV) type I encephalitis is a severe neurological condition.
- Acyclovir is the standard treatment, with resistance being uncommon, particularly in immunocompetent individuals.
Observation:
- A 45-year-old immunocompetent female presented with aphasia and psychomotor slowing.
- Cerebral MRI revealed temporal lobe lesions, and CSF analysis showed inflammation.
- Initial acyclovir treatment failed, necessitating dose escalation and resistance testing.
Findings:
- The patient was diagnosed with HSV type I encephalitis.
- Acyclovir resistance was confirmed due to a thymidine kinase gene mutation (A156V).
- Switching to foscarnet therapy led to dramatic clinical improvement.
Implications:
- This case represents the first reported instance of acyclovir-resistant HSV type I encephalitis in an immunocompetent patient in Austria.
- It underscores the need to suspect and test for acyclovir resistance in cases of treatment failure or clinical deterioration.
- Early identification and alternative therapies like foscarnet are crucial for managing resistant HSV encephalitis.
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