Herpes Encephalitis Resulting in Neurologic Sequelae: Case Report

Herpes simplex virus (HSV) is the most common viral cause of sporadic encephalitis. Fever, altered consciousness and focal neurologic signs are typical clinical features of HSV encephalitis. Untreated cases have high mortality. Even with appropriate and timely treatment, permanent neurologic sequelae can still be seen. The diagnostic gold standard is the detection of HSV-DNA in the cerebrospinal fluid, and this method has a high specificity and sensitivity. In HSV diagnosis, cerebral magnetic resonance (MR) is the best radiological examination. In this paper a case with fever and mental confusion for five days who was diagnosed as HSV encephalitis is presented. HSV-polymerase chain reaction (PCR) was positive in the cerebrospinal fluid and cerebral MR revealed hemorrhage in the temporal lobe. Despite acyclovir treatment, sequelae like cognitive disorders and polyphagia were seen. In conclusion, mortality and morbidity of HSV encephalitis can be reduced with early treatment. Acyclovir should be started in patients with suspected HSV encephalitis until proven otherwise.