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Expanded spectrum of herpes simplex encephalitis in childhood
Y Schlesinger1, R S Buller, J E Brunstrom
1Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110.
The Journal of Pediatrics
|February 1, 1995
Summary
A new polymerase chain reaction (PCR) method accurately detects herpes simplex virus (HSV) type 1 in children with encephalitis. This PCR test aids in diagnosing atypical HSV encephalitis, which presents differently in young children.
Area of Science:
- Neurology
- Infectious Diseases
- Molecular Biology
Background:
- Herpes simplex virus (HSV) encephalitis is a serious neurological condition.
- Traditional diagnostic methods for HSV encephalitis may not be sensitive enough in young children.
- Atypical presentations of HSV encephalitis in preschool-aged children are not well-characterized.
Observation:
- A novel polymerase chain reaction (PCR) method was developed to detect HSV DNA in cerebrospinal fluid.
- This PCR assay targets a specific segment of the HSV DNA polymerase gene.
- Magnetic resonance imaging (MRI) revealed diffuse or multifocal brain involvement in three young children with encephalitis.
Findings:
- The PCR method successfully diagnosed herpes simplex virus type 1 (HSV-1) infection in three children aged 7–13 months.
- The diagnosed HSV-1 encephalitis cases presented atypically, lacking characteristic temporal lobe involvement.
- MRI detected abnormalities not visible with computed tomography (CT), highlighting its superior sensitivity for diffuse brain involvement.
Implications:
- The spectrum of HSV encephalitis in preschool-aged children includes multifocal or diffuse brain involvement.
- MRI is crucial for detecting these atypical presentations of HSV encephalitis.
- The developed PCR method shows promise for early HSV encephalitis diagnosis, though further validation is needed.