Herpes simplex virus central nervous system relapse during treatment of infantile spasms with corticotropin.

Abstract:

:Here we report an infant who had herpes simplex virus (HSV) encephalitis and sustained severe bilateral damage to the posterior frontal lobes, postcentral gyri, and the thalami despite intravenous acyclovir treatment. At 7 months of age, the patient developed infantile spasms and was treated with corticotropin injections. After 10 days of corticotropin treatment, she developed lethargy, fever, and opisthotonic posturing. Her cerebrospinal fluid again was positive for HSV DNA, indicating recurrent HSV encephalitis, and repeat MRI revealed new lesions of the right frontal, parietal, temporal, and occipital lobes. Immunosuppression by corticotropin may have led to the reactivation of the HSV encephalitis. Corticotropin should be relatively contraindicated for use when a patient has a history of HSV infection, or intravenous acyclovir should be administered concurrently.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Bonkowsky JL,Filloux FM,Byington CL

doi

10.1542/peds.2005-1867

subject

Has Abstract

pub_date

2006-05-01 00:00:00

pages

e1045-8

issue

5

eissn

0031-4005

issn

1098-4275

pii

peds.2005-1867

journal_volume

117

pub_type

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