Journal Article

Exacerbation of Herpes Simplex Encephalitis after Successful Treatment with Acyclovir

Yoshinori Ito, Hiroshi Kimura, Yumi Yabuta, Yoshihiro Ando, Tsukasa Murakami, Masashi Shiomi and Tsuneo Morishima

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 1, pages 185-187
Published in print January 2000 | ISSN: 1058-4838
Published online January 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313618
Exacerbation of Herpes Simplex Encephalitis after Successful Treatment with Acyclovir

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Herpes simplex encephalitis (HSE) in children sometimes exacerbates after successful treatment; yet the frequency, etiology, and clinical features of exacerbation remain unclear. We report data for 27 children with HSE confirmed by polymerase chain reaction (PCR) analysis; all were successfully treated with acyclovir, but 7 (26%) had a relapse of encephalitic illness. In 2 of those 7, serial examination with a PCR assay showed that herpes simplex virus (HSV) DNA reappeared temporarily in the cerebrospinal fluid (CSF). For 5 of the 7 patients, a second course of acyclovir therapy was effective. Coxsackievirus A9 was isolated from CSF of 1 case patient during subsequent exacerbation. The total dose during initial acyclovir therapy was significantly lower in the relapse group than in the control group (P = .027). In conclusion, exacerbation of HSE in children may be more common than previously recognized. It is suggested that the replication of HSV or another viral pathogen caused a second encephalitic illness (HSE) in some cases.

Journal Article.  1623 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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