Herpetic encephalitis confirmed by real time polymerase chain reaction: case report

Abstract

The herpetic encephalitis is a serious disease associated to the herpes virus simplex 1 or 2 with high mortality, permanent incidence of complications and neurological sequels. It appears in endemic form and in immunocompetent patients. It can be shown like a classical manifest of infectious encephalitis, with fever, migraine and alteration in the conscience level. Due to the commitment of the temporary lobe, the clinical manifestations can also include hallucinations, aphasia and changes of personality. The sequels in the treated patients are significant.

OBJECTIVE: to show the importance of early molecular diagnosis in patients with suspected herpetic encephalitis infection.

METHODS: the diagnosis of the herpetic encephalitis has changed in the last years thanks to the coming of the real time polymerase chain reaction for herpes simplex virus in cerebrospinal fluid, a fast strategy with high sensitivity and specificity that has allowed to replace the suspect diagnoses made by tomography axial computerized or electroencephalogram, or the low yields of the viral isolation in the cerebrospinal fluid.

RESULTS: A clinical case report of a patient attended in our hospital with image and neuropsychological studies compatible for herpetic encephalitis, and confirmed diagnosis by real time polymerase chain reaction is described.

CONCLUSIONS: the results of laboratory and the early diagnosis are critical for the precocious treatment and the evolution of the patient.