Stroke or encephalitis?
Viral encephalitis is associated with significant morbidity and mortality, particularly when appropriate management is omitted as a result of delayed diagnosis. A case of herpes simplex virus type 1 (HSV-1) encephalitis is presented, demonstrating that the presentation of confusion, speech difficulties and fever with non-specific early brain CT appearances can easily be misdiagnosed as pneumonia with stroke. This case highlights the need for increased awareness of HSV-1 encephalitis among emergency physicians and radiologists, given that the early spectrum of clinical and CT findings can mimic the more common diagnoses of sepsis and stroke.
Townend
Bradley S
BS
Neurosciences Department, Gosford Hospital, Gosford, New South Wales, Australia. btownend@doh.health.nsw.gov.au
Hanson
Julian A
JA
Sturm
Jonathan W
JW
Whyte
Scott
S
D000212:Acyclovir / Q000627:therapeutic use; D000369:Aged, 80 and over; D003221:Confusion / Q000209:etiology; D003937:Diagnosis, Differential; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D005260:Female; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D006801:Humans; D020521:Stroke / Q000175:diagnosis*; D016896:Treatment Outcome
D000212:Acyclovir