Herpes simplex virus type 1 encephalitis associated with acute retinal necrosis syndrome in an immunocompetent patient.
OBJECTIVE
The onset of acute retinal necrosis secondary to herpes simplex encephalitis is exceptional. We report such an association in an immunocompetent patient, in whom the genome of herpes simplex virus type 1 (HSV-1) was identified successively at both sites of infection.


METHODS
Polymerase chain reaction (PCR) assay of HSV-1 in cerebrospinal fluid (CSF) and aqueous humour.


RESULTS
An immunocompetent patient aged 40 years presented with HSV-1 encephalitis, which was confirmed by imaging, viral serology and identification of the HSV-1 genome in the CSF. The subject's immunological profile was normal. The patient was treated with foscavir. Six weeks after clinical recovery and negative PCR, the patient presented with a unilateral acute retinal necrosis syndrome. Polymerase chain reaction of the aqueous humour was positive, while serology and PCR of the CSF remained negative.


CONCLUSIONS
Identification of the HSV-1 genome at the two successive sites of infection stresses the possibility of brain-to-eye transmission of HSV-1.
Gain
Philippe
P
Department of Ophthalmology, Bellevue Hospital, Saint-Etienne, France. philippe.gain@univ-st-etienne.fr
Chiquet
Christophe
C
Thuret
Gilles
G
Drouet
Emmanuel
E
Antoine
Jean-Christophe
JC
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D002555:Cerebrospinal Fluid / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D017245:Foscarnet / Q000627:therapeutic use; D016679:Genome, Viral; D006561:Herpes Simplex / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016133:Polymerase Chain Reaction; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*
D000998:Antiviral Agents; D004279:DNA, Viral; D017245:Foscarnet