title: Brain irradiation and antioedematous dexamethasone treatment--risk factors for herpes simplex encephalitis?
abstract: Herpes simplex encephalitis (HSE) could result from the reactivation of an endogenous latent herpes simplex virus (HSV) in sensory ganglia or in brain parenchyma. Virus replication and a new lytic virus cycle may be triggered by a wide variety of factors. One of these might be irradiation as suggested by experimental evidence obtained in mouse trigeminal ganglia. Here we report the occurrence of HSE in a 52 years old woman two months after brain irradiation (40 Gray in 20 fractions) and dexamethasone administration for a metastatic brain tumor. HSE has already been observed in a clinical context very similar to that reported here, suggesting that brain irradiation together with corticoid therapy may, in some rare patients, favour the occurrence of HSV reactivation and HSE.
authors.affiliation: Institute of Pathology, University Hospital, Basel, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Dragoje
authors.forename: M
authors.initials: M
authors.lastname: Tolnay
authors.forename: P
authors.initials: P
authors.lastname: Dalquen
authors.forename: A
authors.initials: A
authors.lastname: Probst
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects*; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary; D016371:Cranial Irradiation / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009894:Opportunistic Infections / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D010166:Palliative Care; D011879:Radiotherapy Dosage
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003907:Dexamethasone