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Relapse of herpes simplex encephalitis after conventional acyclovir therapy.
K E VanLandingham1, H B Marsteller, G W Ross
1Department of Neurology, University of Virginia School of Medicine, Charlottesville 22908.
JAMA
|February 19, 1988
Summary
Acyclovir sodium is recommended for herpes simplex encephalitis. Relapse occurred after a 10-day treatment, suggesting longer therapy may be needed for herpes simplex virus type 1 infections.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Herpes simplex encephalitis (HSE) is a severe neurological condition.
- Acyclovir sodium is the primary treatment for HSE.
Observation:
- An immunocompetent patient received a 10-day course of intravenous acyclovir sodium for HSE.
- The patient initially improved but experienced a relapse four days post-treatment.
Findings:
- A brain biopsy confirmed acyclovir-sensitive herpes simplex virus type 1 (HSV-1).
- The relapse indicated potential inadequacy of the standard 10-day acyclovir course.
Implications:
- Extended acyclovir therapy (14–21 days) may be necessary for HSE treatment.
- This finding could inform clinical guidelines for managing HSE, particularly HSV-1 cases.