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Herpes simplex encephalitis presenting with normal CSF analysis
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2013; 23 (11): 815-817
en Inglés | IMEMR | ID: emr-132879
ABSTRACT
A 28 years old female presented with headache, fever, altered sensorium and right side weakness for one week. She was febrile and drowsy with right sided hemiplegia and papilledema. Tuberculous or bacterial meningitis, tuberculoma and abscess were at the top of the diagnosis list followed by Herpes simplex meningo-encephalitis [HSE]. MRI showed abnormal signal intensity of left temporal lobe without significant post-contrast enhancement and midline shift. CSF examination was normal, gram stain and Ziehl-Neelsen stain showed no micro-organism, or acid fast bacilli. CSF for MTB PCR was negative. PCR DNA for Herpes simplex 1 on CSF was detected. Acyclovir was started and the patient was discharged after full recovery. A high index of suspicion is required for HSE diagnosis in Pakistan where other infections predominantly affect the brain and HSE may be overlooked as a potential diagnosis.
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Índice: IMEMR (Mediterraneo Oriental) Asunto principal: Aciclovir / Imagen por Resonancia Magnética / Líquido Cefalorraquídeo / Reacción en Cadena de la Polimerasa / Herpesvirus Humano 1 Tipo de estudio: Informe de Casos Límite: Adulto / Femenino / Humanos Idioma: Inglés Revista: J. Coll. Physicians Surg. Pak. Año: 2013

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Índice: IMEMR (Mediterraneo Oriental) Asunto principal: Aciclovir / Imagen por Resonancia Magnética / Líquido Cefalorraquídeo / Reacción en Cadena de la Polimerasa / Herpesvirus Humano 1 Tipo de estudio: Informe de Casos Límite: Adulto / Femenino / Humanos Idioma: Inglés Revista: J. Coll. Physicians Surg. Pak. Año: 2013