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Herpes simplex encephalitis in infants and children

W J Shian1, C S Chi

  • 1Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|January 1, 1994
PubMed
Summary

Herpes simplex encephalitis (HSE) in children is a severe condition with lasting effects, even with treatment. Early diagnosis and prompt intravenous acyclovir are crucial for improving outcomes in pediatric HSE cases.

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Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroimaging

Background:

  • Herpes simplex encephalitis (HSE) affects 2-4 million people annually, with a significant proportion being children.
  • Early diagnosis and effective antiviral therapy are critical for improving outcomes in pediatric HSE.
  • HSE presents a high mortality and morbidity rate, particularly in younger patients.

Purpose of the Study:

  • To review clinical, neuroimaging, and electroencephalographic findings in Chinese children diagnosed with HSE.
  • To evaluate the effectiveness of early diagnosis and treatment in pediatric HSE cases.
  • To highlight the importance of prompt intervention despite potential diagnostic challenges.

Main Methods:

  • Retrospective review of hospital records, neuroimages, and EEG findings for 10 pediatric HSE patients over 7 years.
  • Diagnosis confirmed via clinical presentation, serum, and cerebrospinal fluid (CSF) serology.
  • Analysis of clinical manifestations, CSF analysis, brain CT, MRI, and EEG data.

Main Results:

  • Common symptoms included fever, consciousness disturbance, and seizures.
  • CSF typically showed mild pleocytosis, elevated protein, and normal glucose ratio; brain imaging revealed temporal/frontal abnormalities.
  • EEG commonly showed generalized slow activity or epileptiform discharges; survivors often experienced neurodevelopmental deficits or epilepsy.

Conclusions:

  • HSE is a severe pediatric illness with significant mortality and morbidity, even with acyclovir treatment.
  • Prompt initiation of intravenous acyclovir is essential for managing HSE in children.
  • While diagnostic tools like CSF analysis, EEG, and neuroimaging are valuable, treatment should not be delayed in suspected cases, even with non-definitive findings.

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