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Early-onset herpes simplex encephalitis type 1 triggered by COVID-19 disease: A case report

Kai Inoue1, Hanako Aoki1, Shuta Toru1

  • 1Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan.

Radiology Case Reports
|January 8, 2024
PubMed

Insights

Coronavirus disease 2019 (COVID-19) can trigger herpes simplex virus type 1 (HSV-1) encephalitis. This case highlights early HSV-1 encephalitis in a COVID-19 patient, emphasizing prompt neurological assessment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to systemic inflammation and temporary immunosuppression.
  • Reactivation of herpes simplex virus type 1 (HSV-1) has been frequently associated with COVID-19.
  • Encephalitis cases in COVID-19 patients are rising, necessitating investigation into potential triggers.

Observation:

  • A 66-year-old female presented with impaired consciousness 7 days after COVID-19 symptom onset.
  • MRI revealed typical HSV-1 encephalitis findings, including hyperintense lesions in the temporal lobe, insular cortices, and medial frontal lobe on diffusion-weighted imaging.
  • This case represents a rare instance of HSV-1 encephalitis occurring within 7 days of COVID-19 symptom onset.

Findings:

  • The patient developed herpes simplex virus type 1 (HSV-1) encephalitis following COVID-19 infection.
  • Neurological symptoms and characteristic MRI findings were observed within a week of initial COVID-19 presentation.
  • This suggests a potential causal link or exacerbation of HSV-1 reactivation by COVID-19.

Implications:

  • Clinicians should consider HSV-1 encephalitis in the differential diagnosis for COVID-19 patients presenting with neurological complications.
  • Early recognition and management of HSV-1 encephalitis are crucial, even in the early stages of COVID-19.
  • Further research is needed to understand the mechanisms linking COVID-19 and HSV-1 reactivation leading to encephalitis.

Keywords:
AcyclovirCOVID-19HSV-1 encephalitisReactivationVidarabine

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