title: Management of HSV-1 encephalitis due to reactivation of HSV-1 during late pregnancy.
abstract: A previously healthy 31-year-old G4P2 woman at 33 weeks of gestation was admitted as an emergency with a pyrexia of 39°C, vomiting, headache and neck stiffness associated with photophobia, phonophobia and visual and auditory symptoms. There were no heraldic signs of eclampsia. Polymerase chain reaction and testing for herpes simplex virus in the cerebrospinal fluid diagnosed herpes simplex-1 meningoencephalitis. Following acyclovir, the clinical course improved. Spontaneous vaginal delivery occurred at 39 weeks of gestation with epidural analgesia using ropivacaine. Mother and child were neurologically normal and healthy 15 months later. Early administration of acyclovir is essential to reduce the risk of neurological complications. After treatment and a negative polymerase chain reaction for herpes simplex virus in the cerebrospinal fluid, epidural analgesia with local anesthetic and sufentanil is possible.
authors.affiliation: Départment d'Anesthésie-Réanimation Adultes, Clermont-Ferrand Cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Pascal
authors.forename: S
authors.initials: S
authors.lastname: Perbet
authors.forename: N
authors.initials: N
authors.lastname: Bourdel
authors.forename: D
authors.initials: D
authors.lastname: Da Ines
authors.forename: X
authors.initials: X
authors.lastname: Tran
authors.forename: C
authors.initials: C
authors.lastname: Chartier
authors.forename: M
authors.initials: M
authors.lastname: Bonnin
authors.forename: G
authors.initials: G
authors.lastname: Mage
authors.forename: J-E
authors.initials: JE
authors.lastname: Bazin
authors.forename: J-M
authors.initials: JM
authors.lastname: Constantin
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001921:Brain / Q000821:virology; D003937:Diagnosis, Differential; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D018259:Herpesvirus 1, Human / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D011263:Pregnancy Trimester, Third; D014775:Virus Activation
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir