title: Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy.
abstract: A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV) type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.
authors.affiliation: Department of Pediatrics, Alain Hospital-affiliate to Medical University of Vienna, Alain, United Arab Emirates .
authors.forename: Ratna B
authors.initials: RB
authors.lastname: Basak
authors.forename: Varsha
authors.initials: V
authors.lastname: Malpani
authors.forename: Khalid
authors.initials: K
authors.lastname: Kakish
authors.forename: Susan
authors.initials: S
authors.lastname: Vargese
authors.forename: Nageshwar
authors.initials: N
authors.lastname: Chauhan
authors.forename: Andreas
authors.initials: A
authors.lastname: Boeck