TITLE

Relapsing Herpes simplex virus encephalitis despite high-dose acyclovir therapy: a case report

AUTHOR(S)
Devrim, İlker; Tezer, Hasan; Haliloğlu, Göknur; Kara, Ateş; Seçmeer, Gülten
PUB. DATE
July 2008
SOURCE
Turkish Journal of Pediatrics;2008, Vol. 50 Issue 4, p380
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Central nervous system infection of Herpes simplex virus (HSV) is the most common etiologic agent of the non-epidemic fatal form of encephalitis. Relapse of HSV encephalitis is rare in childhood. In this report, we present our experience in a 36-month-old child with relapse of HSV encephalitis after 14-day acyclovir therapy. A 36-month-old boy who was presented with deterioration in speech and motor functions and fluctuation of consciousness was treated with acyclovir for 14 days for HSV encephalitis. He was discharged since his cerebrospinal fluid findings returned to normal range and clinical improvement was seen. Ten days later, he was readmitted to our clinic with acute fever, focal convulsions and choreoathetoid movements, and altered consciousness. Acyclovir was started immediately, but he died on the 17th day because of respiratory failure. Relapses due to HSV encephalitis are rare and limited to a small number of case reports in the literature. Persistence of HSV, detection of high viral load or detection of HSV by polymerase chain reaction, prior corticosteroid therapy, low total dosage of acyclovir (especially for children under 2 years of age) and short duration of therapy were suspected risk factors. Even absence of pleocytosis and normal cerebrospinal fluid biochemistry in our patient after treatment did not indicate eradication of HSV. In our opinion, treatment duration of HSV encephalitis, especially in small children, must be at least 21 days. Clinical and experimental studies are required since only case reports on this topic exist.
ACCESSION #
35401365

 

Related Articles

  • Usefulness of Adding Multiplex Nested-Polymerase Chain Reaction Assay of Cerebrospinal Fluid Samples to Routine Diagnostic Testing for Herpesvirus Encephalitis. Frías, C.; Matas, L.; Ferré, X.; Millán, M.; Martí, S.; Hernández, A.; Ausina, V. // European Journal of Clinical Microbiology & Infectious Diseases;Sep2001, Vol. 20 Issue 9, p670 

    The present study was conducted to assess the usefulness of adding the multiplex nested-polymerase chain reaction assay of cerebrospinal fluid samples to routine diagnostic testing for herpesvirus encephalitis and to monitor the efficacy of therapy. Cerebrospinal fluid samples from 45 patients...

  • Digestive Manifestations in an Immunocompetent Adult with Varicella. Maillot, Céline; Riachi, Ghassan; François, Arnaud; Ducrotte, Philippe; Lerebours, Eric; Hemet, Jacques; Colin, Raymond // American Journal of Gastroenterology;Aug1997, Vol. 92 Issue 8, p1361 

    A case of varicella with pancreatic pain as a first manifestation, a typical papulovesicular rash, pulmonary and hepatic and esophageal localizations occurring in an immunocompetent adult is reported. Treatment with intravenous acyclovir resulted in a prompt improvement and recovery in less than...

  • Acyclovir cream prevents clinical and thermographic progression of recrudescent herpes labialis beyond the prodromal stage. Biagioni, Paul A.; Lamey, Philip-John // Acta Dermato-Venereologica;4/20/98, Vol. 78 Issue 1, p46 

    Early treatment of recrudescent herpes labialis over the symptomatic area has been claimed to inhibit the clinical signs of recrudescent herpes labialis. Electronic infrared thermography can both recognise the prodromal phase and identify the area requiring drug therapy. Our objective was to use...

  • Stress Studies on Acyclovir. V.R. Sinha; Monika; A. Trehan; Manoj Kumar; S. Singh; J.R. Bhinge // Journal of Chromatographic Science;Jul2007, Vol. 45 Issue 6, p319 

    Acyclovir is an antiviral drug of choice in the treatment of many types of herpes virus infections, including genital herpes simplex infections, herpetic conjunctivitis, herpes simplex encephalitis, etc. The present study describes the degradation behavior of acyclovir under different...

  • HERPES. Tatum IV, William O.; Kaplan, Peter W.; Jallon, Pierre // Epilepsy A to Z: A Concise Encyclopedia;2009, p158 

    An encyclopedia entry for "herpes simplex type 1 encephalitis (HSE) " is presented. It is considered the most common cause of sporadic viral encephalitis and is associated with seizures in adults, occurring in approximately 3/100,000 persons annually and accounting for 95% of all fatal cases of...

  • Herpes treatment may be effective against HIV.  // Infectious Disease News;Oct2008, Vol. 21 Issue 10, p40 

    The article discusses research being done on the use of herpes treatment for human immunodeficiency virus (HIV). It references a study published in the 2008 issue of "Cell Host & Microbe." The study found that acyclovir not only targets tissue infected with herpes but also showed activity...

  • Perspectives on Viral Eye Diseases.  // Review of Optometry;May2013 Review Supplement, p21A 

    The article discusses the symptoms associated with viral eye infections along with the preventive measures and therapeutic approaches which should be undertaken for its treatment. It mentions that the herpes family of viruses is the primarily infectious agents which causes red inflamed eye and...

  • A Retrospective, Case-Control Study of Acyclovir Resistance in Herpes Simplex Virus. Malvy, Denis; Treilhaud, Michèle; Bouée, Stéphane; Crochard, Anne; Vallée, Denis; El Hasnaoui, Abdelkader; Aymard, Michèle // Clinical Infectious Diseases;8/1/2005, Vol. 41 Issue 3, p320 

    Background. Occasional cases of acyclovir resistance have been documented in the treatment of herpes simplex virus (HSV) infection. Thirty-eight subjects with acyclovir-resistant infections were identified in an epidemiological surveillance program involving 1811 HSV-infected subjects in France....

  • Herpes Simplex Suppression and HIV Infection.  // Clinical Infectious Diseases;11/1/2008, Vol. 47 Issue 9, pv 

    The article reports on the study regarding the association of preexisting herpes simplex virus (HSV)-2 infection with a doubling or tripling of the risk of acquisition of HIV infection. It analyzes the effect of suppression of HSV-2 infection whether it would reduce the risk of HIV infection. It...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics