Reactivation and centripetal spread of herpes simplex virus complicating acoustic neuroma resection.
BACKGROUND
Herpes simplex is a common human pathogen that has rare but severe manifestations including encephalitis.


METHODS
A 44-year-old man underwent uneventful resection of an acoustic neuroma. Postoperatively, he developed swinging pyrexia, vomiting, and episodic confusion. Analysis of cerebrospinal fluid showed a lymphocytosis, and polymerase chain reaction revealed herpes simplex DNA. After treatment of herpes encephalitis with acyclovir, the patient made a good recovery.


CONCLUSIONS
Herpes encephalitis is a rare complication of neurosurgical procedures, and the most likely etiology is reactivation of latent infection from manipulation of cranial nerves.
Jalloh
Ibrahim
I
Department of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. ibrahim.jalloh@nuh.nhs.uk
Guilfoyle
Mathew R
MR
Lloyd
Simon K W
SK
Macfarlane
Robert
R
Smith
Chris
C
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003244:Consciousness Disorders / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D020803:Encephalitis, Herpes Simplex / Q000209:etiology* / Q000503:physiopathology / Q000821:virology; D005154:Facial Nerve / Q000601:surgery / Q000821:virology; D005155:Facial Nerve Diseases / Q000150:complications* / Q000821:virology; D005334:Fever / Q000821:virology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009464:Neuroma, Acoustic / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D012008:Recurrence; D018139:Simplexvirus / Q000235:genetics*; D014057:Tomography, X-Ray Computed; D000159:Vestibulocochlear Nerve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014839:Vomiting / Q000821:virology
D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir