Exploring the psychiatric spectrum of herpes simplex virus encephalitis

Herpes simplex encephalitis (HSE) typically presents with fever, seizures, and altered sensorium, but atypical presentations with predominant psychiatric symptoms can delay diagnosis and treatment. We report a case series of three patients, who initially exhibited psychotic symptoms, including hallucinations and mood disturbances, without classic neurological signs. Diagnosis was confirmed via cerebrospinal fluid analysis and MRI findings. Early antiviral therapy led to prompt recovery. This series highlights the importance of considering HSE in acute psychiatric presentations to prevent misdiagnosis and ensure timely intervention.