Diseases that mimic herpes simplex encephalitis. Diagnosis, presentation, and outcome. NIAD Collaborative Antiviral Study Group.
A total of 432 patients underwent brain biopsy for presumptive herpes simplex encephalitis. Three patient groups were identified. The first group, 195 patients (45%), had herpes simplex encephalitis confirmed by the isolation of herpes simplex virus from brain tissue at biopsy (193 patients) or autopsy (2 patients). The second group, 95 patients (22%), had diseases that were identified but that were not caused by herpes simplex virus. Three subgroups were recognized: (1) 38 patients (9%) with treatable disease, (2) 40 patients (9%) with nontreatable but diagnosed viral infection, and (3) 17 patients (4%) with identified diseases neither of viral etiology nor treatable. The third group, 142 patients (33%), remained without a diagnosis. Clinical presentation of patients in the second group was similar to that of those with herpes simplex encephalitis and those without a diagnosis. Patients in the subgroup with nontreatable but diagnosed viral infections had the greatest likelihood of returning to normal.
Whitley
R J
RJ
Department of Pediatrics, University of Alabama, Birmingham.
Cobbs
C G
CG
Alford
C A
CA
Soong
S J
SJ
Hirsch
M S
MS
Connor
J D
JD
Corey
L
L
Hanley
D F
DF
Levin
M
M
Powell
D A
DA
D000293:Adolescent; D000367:Age Factors; D001706:Biopsy; D001921:Brain / Q000473:pathology; D003243:Consciousness; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D006561:Herpes Simplex / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D011897:Random Allocation; D018139:Simplexvirus / Q000302:isolation & purification*