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Relapse of herpes simplex encephalitis.

M A Barthez, C Billard, J J Santini

    Neuropediatrics
    |February 1, 1987
    PubMed
    Summary
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    A child with herpes simplex virus (HSV) encephalitis experienced relapse and died despite acyclovir treatment. Autopsy revealed severe brain necrotizing lesions, with no clear demyelination or inflammation, questioning the relapse mechanism.

    Area of Science:

    • Neurology
    • Virology
    • Pathology

    Background:

    • Herpes simplex virus (HSV) encephalitis is a severe neurological infection.
    • Acyclovir is the standard antiviral treatment for HSV encephalitis.
    • Relapse or treatment failure can occur despite appropriate therapy.

    Observation:

    • A child with HSV encephalitis initially improved with acyclovir.
    • The patient later experienced neurological deterioration and death.
    • Autopsy showed severe necrotizing brain lesions without typical demyelination or inflammation.

    Findings:

    • Herpes simplex virus (HSV) was not detected in brain biopsies during relapse or at autopsy.
    • The pathological findings were inconsistent with typical HSV encephalitis relapse.

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  • Review of 14 prior cases suggests complex relapse mechanisms.

    • Implications:

    • The findings challenge the understanding of HSV encephalitis relapse mechanisms.
    • Further research is needed to elucidate why some patients relapse despite treatment.
    • This case highlights the need for continued investigation into treatment strategies for severe HSV encephalitis.