HSV-1 encephalitis complicated by cerebral hemorrhage in an HIV-positive person.
Although herpes simplex virus type 1 (HSV-1) is the most common cause of sporadic encephalitis in immunocompetent adults, it is an unusual cause of encephalitis in patients with HIV/AIDS. We report the case of a 56-year-old man with recently diagnosed HIV infection who presented with subacute mental status changes, fever, and temporal lobe abnormalities evident on brain imaging. Results of a polymerase chain reaction assay of the cerebrospinal fluid were positive for HSV-1. His course was complicated by 2 episodes of cerebral hemorrhage. He ultimately improved after surgical decompression, treatment with acyclovir, and a switch from a protease inhibitor-based antiretroviral regimen to one including an integrase inhibitor.
Li
Jonathan Z
JZ
Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Sax
Paul E
PE
D000212:Acyclovir / Q000008:administration & dosage; D000998:Antiviral Agents / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery / Q000821:virology*; D020803:Encephalitis, Herpes Simplex / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications*; D018259:Herpesvirus 1, Human; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D012640:Seizures / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000998:Antiviral Agents; D000212:Acyclovir