Herpes simplex virus type 2 encephalitis in an elderly immunocompetent male.
An 85-year-old immunocompetent man was hospitalized following the development of increasing confusion and intermittent disorientation over a 48-hour period. Within 48 hours of hospitalization, he was oriented to person only and was unable to follow commands. There were no focal neurologic deficits. Magnetic resonance imaging of the brain showed extensive perivascular demyelination. Lumbar puncture was performed and showed normal opening pressure. Cerebrospinal fluid analysis showed 8 leukocytes (7 lymphocytes), as well as normal glucose and protein levels. Polymerase chain reaction evaluation of cerebrospinal fluid was positive for herpes simplex virus type 2. He was diagnosed with herpes simplex type 2 encephalitis and is to the authors' knowledge the first elderly immunocompetent patient to be reported with this disorder.
Reuter
Matthew D
MD
Department of Medicine, St. John's Mercy Medical Center, St. Louis, Missouri 63141, USA.
Manian
Farrin A
FA
Kershaw
Melissa A
MA
Alpert
Martin A
MA
D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male