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Herpes simplex encephalitis: a diagnostic and therapeutic reapprisal
P Satishchandra1, M Nandini, S K Shankar
1Department of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore.
Summary
Herpes Simplex Encephalitis (HSE) is likely underdiagnosed in India. Early diagnosis and treatment with acyclovir improved survival rates in patients with this serious brain infection.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Herpes Simplex Encephalitis (HSE) is a significant cause of morbidity, yet appears underdiagnosed in India.
- The rising incidence of Acquired Immunodeficiency Syndrome (AIDS) may increase the prevalence of HSE as an opportunistic infection.
Purpose of the Study:
- To review the clinical features and laboratory findings of nine HSE cases over 12 years.
- To highlight the importance of rapid diagnosis and early antiviral treatment for HSE.
Main Methods:
- Diagnosis was confirmed through brain biopsy (1), virological studies (6), and autopsy (3).
- Immunocytochemistry was used to detect viral antigens in brain tissue and cerebrospinal fluid (CSF) cells.
- Virus isolation was attempted in positive cases.
Main Results:
- Rapid diagnosis was achieved using immunocytochemistry in several cases.
- Virus isolation was successful in two cases.
- Three patients treated with acyclovir survived with varying degrees of morbidity, while four untreated patients expired.
Conclusions:
- Early diagnosis and prompt treatment with acyclovir are crucial for improving outcomes in Herpes Simplex Encephalitis.
- HSE management in India requires enhanced diagnostic strategies and timely intervention.