title: Diseases that mimic herpes simplex encephalitis. Diagnosis, presentation, and outcome. NIAD Collaborative Antiviral Study Group.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of Alabama, Birmingham.
authors.forename: R J
authors.initials: RJ
authors.lastname: Whitley
authors.forename: C G
authors.initials: CG
authors.lastname: Cobbs
authors.forename: C A
authors.initials: CA
authors.lastname: Alford
authors.forename: S J
authors.initials: SJ
authors.lastname: Soong
authors.forename: M S
authors.initials: MS
authors.lastname: Hirsch
authors.forename: J D
authors.initials: JD
authors.lastname: Connor
authors.forename: L
authors.initials: L
authors.lastname: Corey
authors.forename: D F
authors.initials: DF
authors.lastname: Hanley
authors.forename: M
authors.initials: M
authors.lastname: Levin
authors.forename: D A
authors.initials: DA
authors.lastname: Powell
mesh_terms: 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*