چكيده لاتين :
Herpes Simplex encephalitis (HSE) is a life threatening outcome of Herpes
simplex virus (HSV) infection of the central nervous system (CNS). HSV
accounts for 2-5 percent of all cases of enc ephalitis.
One third of cases occur in those younger than 20 years old and one half
in those older than 50 years old.
Clinical diagnosis is recommended in the encephalopathic, febrile patients
with focal neurological signs. However, the clini cal findings are not
pathogonomic because numerous other diseases of CNS can mimic HSE.
Diagnosis should be confirmed based on medical history, analysis of
cerebrospinal fluid (CSF) for protein and glucose contents, the cellular
analysis and id entifying the pathogens by serology and Polymerase Chain
Reaction (PCR) amplification .
The diagnostic gold standard is the detection of HSV DNA in the cerebrospinal
fluid by PCR. But negative results need to be interpreted regarding the
patients clini cal signs and symptoms and the time of CSF sampling. Spike
and slow wave patterns is observed in Electroencephalogram (EEG).
Neuroimaging, especially Magnetic Resonance Imaging (MRI) is essential
for evaluating the patients, whi ch shows temporal lobe edema or hemorrhage.
All patients with HSE should be treated by intravenous Acyclovir (1 Omglkg
q8hr for 14-21 days). After completing therapy, PCR of the CSF can confirm
the elimination of replicating virus, assisting further management of the
patient.
