Herpes simplex encephalitis as a complication of neurosurgical procedures: report of 3 cases and review of the literature. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Jaques, David; Bagetakou, Spyridoula; L'Huillier, Arnaud; Bartoli, Andrea; Vargas, Maria-Isabel; Fluss, Joel; Kaiser, Laurent
• Is Part Of: Virology journal. Volume 13:Issue 1(2016)
• Page Start: 1
• Page End: 9
• Publication Date: 2016-12
• Subjects: Herpes simplex virus -- Meningitis -- Encephalitis -- Neurosurgery -- Complication -- Postoperative; Virology -- Periodicals; 579.2
• DOI: 10.1186/s12985-016-0540-4
• Languages: English
• ISSNs: 1743-422X

Abstract

Abstract Background Herpes simplex virus (HSV) is the most common identified cause of focal encephalitis worldwide. However, postoperative HSV encephalitis (HSVE) is a rare complication of neurosurgical procedures and a significant clinical challenge Method We describe 3 cases of postoperative HSVE and review all published reports. A total of 23 cases were identified. Discussion Clinical heterogeneity represents a diagnostic challenge in the postoperative setting. Cerebral magnetic resonance imaging showed typical findings in a minority of patients only, whereas HSV-specific polymerase chain reaction on the cerebrospinal fluid proved to be a valuable test. The postoperative viral pathophysiology remains a subject of debate. The rate of adverse outcome is high and early antiviral treatment seems to be a strong predictor of clinical outcome. Conclusion We recommend early empirical treatment for any patient presenting with post-neurosurgical lymphocytic meningo-encephalitis, and prophylactic antiviral treatment for patients with a history of previous HSVE who will undergo a neurosurgical procedure.