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HSV-1 encephalitis relapse after epilepsy surgery: a case report and review of the literature.

Abstract：

:Herpes simplex encephalitis relapses have been rarely reported, with only few cases occurring after neurosurgical interventions. A young man presented a late herpes simplex encephalitis relapse after left antero-mesial temporal resection for his refractory temporal lobe epilepsy. Eight days after surgery, he developed fever and aphasia. CSF PCR revealed more than 12,000 copies/ml of HSV-1 DNA. Intravenous acyclovir was immediately started with a complete recovery. Postoperative herpes simplex encephalitis can occur as primary infection or as relapse of previous infection. Surgical manipulation of brain parenchyma in the site of a previous infection can act as a trigger for viral reactivation. Early onset of antiviral therapy is fundamental and it is a strong predictor of clinical outcome. Despite no studies on prophylactic treatment with acyclovir in patients with previous herpes simplex encephalitis candidate to neurosurgery are available, we suggest that prophylactic treatment should be recommended.

journal_name

J Neurovirol

journal_title

Journal of neurovirology

authors

Mantero V,Cossu M,Rigamonti A,Fiumani A,Basilico P,Tassi L,Salmaggi A

doi

10.1007/s13365-019-00796-1

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

138-141

issue

1

eissn

1355-0284

issn

1538-2443

pii

10.1007/s13365-019-00796-1

journal_volume

26

pub_type

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