title: [Two cases of herpes encephalitis with normal cerebrospinal fluid findings].
abstract: In this report, characteristics of two cases of Herpes simplex virus (HSV) encephalitis with normal cerebrospinal fluid (CSF) findings at the time of admission have been discussed and the current literature has been reviewed. The diagnosis of the cases (one was 23 years old male, and the other was 75 years old female patient) was made on the magnetic resonance imaging (MRI) findings concordant with HSV encephalitis, together with HSV-1 DNA positivity by polymerase chain reaction (PCR). Both of the patients were treated with acyclovir (3 x 750 mg/day) lasting for 15 days and 21 days, respectively. The first male patient recovered with mild neurological defects, whereas the second female patient died because of nosocomial pneumonia and septicemia. In conclusion, even the CSF findings are normal, in cases considered to be HSV encephalitis, MRI should be the first radiological diagnostic step and the diagnosis should be confirmed by the detection of HSV DNA in CSF by PCR.
authors.affiliation: Dokuz Eylül Universitesi Tip Fakültesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, Izmir.
authors.forename: Vildan
authors.initials: V
authors.lastname: Avkan Oğuz
authors.forename: Nur
authors.initials: N
authors.lastname: Yapar
authors.forename: Nurbanu
authors.initials: N
authors.lastname: Sezak
authors.forename: Sema
authors.initials: S
authors.lastname: Alp Cavuş
authors.forename: Ziya
authors.initials: Z
authors.lastname: Kuruüzüm
authors.forename: Arzu
authors.initials: A
authors.lastname: Sayiner
authors.forename: Emel
authors.initials: E
authors.lastname: Ada
authors.forename: Nedim
authors.initials: N
authors.lastname: Cakir
authors.forename: Ayşe
authors.initials: A
authors.lastname: Yüce
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000150:complications; D004279:DNA, Viral / Q000134:cerebrospinal fluid*; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000188:drug therapy; D017809:Fatal Outcome; D005260:Female; D018259:Herpesvirus 1, Human / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011014:Pneumonia / Q000150:complications; D016133:Polymerase Chain Reaction; D018805:Sepsis / Q000150:complications; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir