Journal article
A Fatal Case of Herpes Simplex Encephalitis with Two False-Negative Polymerase Chain Reactions
Case Reports in Neurology, Vol.10(2), pp.217-222
08/29/2018
DOI: 10.1159/000492053
PMCID: PMC6167650
PMID: 30283319
Abstract
An 88-year-old man presented with a 1-month history of altered mental status and seizures. His electrographic and imaging findings were suggestive of herpes simplex encephalitis (HSE), for which he was empirically treated with acyclovir. He underwent two lumbar punctures 3 days apart; both cerebrospinal fluid analyses tested negative for herpes simplex virus (HSV) by polymerase chain reaction (PCR). These negative results and his continued deterioration after 9 days of acyclovir therapy prompted treatment with steroids for possible autoimmune encephalitis. Shortly after the change in management, the patient died from cardiac arrest. At autopsy, his brain showed both gross and microscopic evidence of encephalitis and was positive for HSV by immunohistochemistry. This fatal case of HSE emphasizes the limitations of HSV PCR and the importance of clinical suspicion in the diagnosis and management of this disease.
Details
- Title: Subtitle
- A Fatal Case of Herpes Simplex Encephalitis with Two False-Negative Polymerase Chain Reactions
- Creators
- Aldo A. MendezAnnaliese BoscoLama Abdel-WahedKendra PalmerKarra A. JonesAnnie Killoran - University of Iowa, Neurology
- Resource Type
- Journal article
- Publication Details
- Case Reports in Neurology, Vol.10(2), pp.217-222
- Publisher
- Karger Publishers
- DOI
- 10.1159/000492053
- PMID
- 30283319
- PMCID
- PMC6167650
- ISSN
- 1662-680X
- eISSN
- 1662-680X
- Copyright
- © 2018 The Author(s)
- Grant note
- Competing Interests: The authors declare that they have no competing interests.
- Language
- English
- Date published
- 08/29/2018
- Academic Unit
- Neurology; Pathology
- Record Identifier
- 9983761183502771
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