Herpesviral encephalitis is encephalitis due to herpes simplex virus. Herpes simplex encephalitis (HSE) is a viral infection of the human central nervous system. Twenty percent of treated patients recover with minor damage. (human herpes virus-6, varicella zoster virus, Epstein-Barr, cytomegalovirus, coxsackievirus, etc.). In August 1999 a very rare and deadly case of herpes simplex type 1 was documented from South Africa. In neonates: HSE is usually caused by herpes simplex virus type 2 (HSV-2) acquired at the time of delivery, and brain involvement is generalised. Other viral causes include CMV, adenovirus, influenza virus, poliovirus, rubella, rabies, arbovirus (eg, California virus, Japanese B encephalitis, St Louis encephalitis, West Nile encephalitis, Eastern and Western equine encephalitis), reovirus (Colorado tick fever virus) and parvovirus B19. Most patients with viral encephalitis present with the symptoms of meningitis (fever, headache, neck stiffness, vomiting) followed by altered consciousness, convulsions, and sometimes focal neurological signs, signs of raised intracranial pressure, or psychiatric symptoms. In patients with suspected viral encephalitis treatment with acyclovir should be started empirically and only discontinued when HSV is ruled out Roos and Tyler, 2010. HSV-2 is associated with HSVE in immunocompromised patients, in whom infection often progresses to a disseminated extent Kennedy and Chaudhuri, 2002. In cases of neonatal HSVE due to HSV-2 exposure during delivery, a latency of typically 11 17 days following delivery has been described prior to clinical presentation Whitley et al. (2005) Clinical impact of ganciclovir-resistant cytomegalovirus infections in solid organ transplant patients.
As a result of immunosuppression, solid organ transplant recipients are at risk of neurologic opportunistic infections that include cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), L. Encephalitis due to herpes simplex virus or CMV is rare in SOT patients. This patient also had positive result on polymerase chain reaction assay for herpes simplex virus, which is both sensitive and specific. Patients with HSE In children older than 3 months and in adults, HSE is usually localized to the temporal and frontal lobes and is caused by HSV-1. Herpesviral encephalitis is encephalitis due to herpes simplex virus.
In addition, laboratory experience has documented the rare recovery of HSV from CSF specimens. Early diagnosis of CNS disease due to HSV is important for initiation of antiviral therapy and effective clinical response. Prognostic factors for this rare affliction are, however, misestimated. Second, herpes simplex virus (HSV) DNA amplification by PCR analysis of CSF has been the reference standard for early diagnosis of HSE since the early 1990s 5 7, thus greatly improving early therapeutic decisions 8, 9. Gordon B,; Selnes OA,; Hart J,; Hanley DF,; Whitley RJ. In: Infectious Disease Pearls, Hanley and Belfus, Inc., Philadelphia, PA, (3) Gilligan, P. Herpes simples virus type 1 and 2 (HSV-1 and HSV- 2) and Varicella- zoster virus (VSV) are members of this subfamily. A new herpesvirus & 150; also called Kaposi’s sarcoma associated herpesvirus has been detected in over 90 of Kaposi’s sarcomas and a rare type of B cell lymphoma from AIDS patients.
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Once a patient has become infected by herpes virus, the infection remains for life. HSV, VZV and CMV have inverted repeat sequences. Diseases caused by Herpes Simplex Viruses. HSV encephalitis is a febrile disease and may result in damage to one of the temporal lobes. Other rare complications of chicken pox are traverse myelitis, Guillian Barre syndrome and aseptic meningitis. Ganciclovir for CMV pneumonitis in solid organ transplant patients appears to reduce morbidity 20. Shock in the setting of adrenal insufficiency caused by viral infection (rare). Indirect effects are due to release of cytokines, chemokines, and growth factors in response to viral infection of the body, which deepen immunosuppression and increase risk of other opportunistic infections 2, 7 10. In the patient being treated for CMV infection, the assays provide an endpoint (a negative assay) for therapy and the reinitiation of prophylaxis. HSV is the most common form of encephalitis in transplant recipients. Mucocutaneous HSV infection in solid-organ transplant recipients should be treated with oral acyclovir while disseminated or deep HSV infection should always be treated with intravenous acyclovir 1, 30. Identify patients with acute liver failure caused by herpes simplex virus infection Discuss the rationale for using long-term acyclovir prophylaxis treatment in stem cell transplant recipients Describe the importance of chromosomal integration of human herpesvirus 6 (HHV-6) for the diagnosis of HHV-6 disease IMPORTANT CME/CNE/CPE INFORMATION. HHV-6 AS A CO-FACTOR IN SOLID ORGAN TRANSPLANT RECIPIENTS Program Directors Kieren A. Controlled studies of long-term high-dose acyclovir prophylaxis against CMV that also demonstrated improvement in outcomes suggest that indirect effects of herpesvirus infections in certain patient populations are related to long-term outcomes. Currently, infections caused by herpes viruses continue to complicate clinical management of transplant patients.