title: Herpes simplex encephalitis and management of acyclovir in encephalitis patients in France.
abstract: This study reports on the clinical profiles of herpes simplex encephalitis (HSE) case-patients and the management of acyclovir prescriptions. We designed a study on the causes of encephalitis in France in 2007. Case-patients fulfilling the inclusion criteria were enrolled in all the hospitals that volunteered to participate. Fifty-five of 253 enrolled case-patients were diagnosed with HSE. Three (5%) HSE patients died and 48 (89%) were discharged with persistent neurological symptoms. All HSE patients were prescribed acyclovir, 10 of whom had a 2-week course; 42 a 3-week course; two received incomplete courses; and one received two courses of 21 days each due to relapse. The acyclovir dosage was reported for 45 adult HSE patients, 25 (53%) of whom received 10 mg/kg t.i.d. and 22 (47%) received 15 mg/kg t.i.d. The mortality rate was low despite 49% of patients being admitted to intensive-care units. A high dose of acyclovir was not associated with a better outcome in HSE patients. Most patients had persisting symptoms on discharge suggesting neuropsychological rehabilitation is an important issue for survivors.
authors.affiliation: Infectious Diseases Unit, University Grenoble 1, Grenoble, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Stahl
authors.forename: A
authors.initials: A
authors.lastname: Mailles
authors.forename: T
authors.initials: T
authors.lastname: De Broucker
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D020804:Encephalitis, Varicella Zoster / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005602:France; D018259:Herpesvirus 1, Human / Q000145:classification / Q000302:isolation & purification*; D018258:Herpesvirus 2, Human / Q000145:classification / Q000302:isolation & purification*; D014645:Herpesvirus 3, Human / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir