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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
Summary
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.
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