Herpes simplex virus encephalitis in pregnancy.
BACKGROUND
Although polymerase chain reaction (PCR) can detect herpes simplex virus (HSV) in the cerebrospinal fluid (CSF), HSV encephalitis remains a significant cause of neurologic impairment in pregnant women. Assessment of fetal contamination also remains a problem.


METHODS
We report two cases in which HSV encephalitis initially was not suspected and led to significant maternal neurologic impairment. In both cases, HSV PCR of CSF confirmed the diagnosis. In one case, fetal serum HSV PCR excluded fetal contamination.


CONCLUSIONS
As soon as encephalitis in pregnancy is suspected, a combination of acyclovir and penicillin is recommended because the potential benefits far outweigh the risks. Using the HSV PCR, HSV infection in the fetus can be diagnosed.
Dupuis
O
O
Department of Obstetrics and Gynecology, Paris XI University, Hôpital Antoine Beclère, Clamart, France. osdupuis@club-internet.fr
Audibert
F
F
Fernandez
H
H
Frydman
R
R
D000328:Adult; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000134:cerebrospinal fluid / Q000175:diagnosis*