Postoperative herpetic encephalitis. Value of Klapper's diagnostic method

A case of a 51 year old female with herpes encephalitis is reported. She underwent surgery for chronic pancreatitis with pseudocyst formation. On the third postoperative day, she developed a severe vesicular nasolabial eruption associated with a deep stupor. Anti-Herpes simplex viral (HSV) antibodies were found in both blood and cerebrospinal fluid. Klapper's anti-HSV antibody ratio was calculated and agreed with the hypothesis of herpes encephalitis. The patient was given nucleoside analogues. She rapidly improved and was discharged from the intensive care unit without any sequelae. The frequency of HSV infection in intensive care patients and the use of Klapper's index for the diagnosis of herpes encephalitis in these patients are then discussed.