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Sinus node dysfunction preceding herpes simplex encephalitis: A case report
Ryo Hayashida1, Kazuhisa Kondo1, Tatsuya Miyazaki1
1Kojunkai Daido Hospital, Nagoya, Japan.
Herpes simplex virus encephalitis can cause sinus node dysfunction. Early diagnosis and treatment are crucial to prevent severe outcomes like permanent pacemaker implantation and death.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Herpes simplex virus encephalitis (HSVE) is a severe neurological infection.
- Sinus node dysfunction (SND) can manifest with various cardiac symptoms.
Observation:
- A 72-year-old male presented with syncope and was diagnosed with sick sinus syndrome, requiring pacemaker implantation.
- Following pacemaker implantation, the patient developed seizures.
Findings:
- Cerebrospinal fluid analysis confirmed herpes simplex virus DNA.
- Head CT revealed evolving low-density lesions in the temporal lobes and insular cortex.
- Despite intravenous acyclovir treatment, neurological deterioration and death from aspiration pneumonia occurred.
Implications:
- HSVE should be considered in the differential diagnosis of patients presenting with SND, particularly in atypical cases.
- Prompt diagnosis of HSVE is critical for improving patient outcomes and potentially avoiding invasive cardiac interventions.
- This case highlights the complex interplay between viral encephalitis and cardiac conduction abnormalities.
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