title: Therapeutic hypothermia for severe adult Herpes simplex virus encephalitis.
abstract: Despite antiviral treatment and advances in critical care, the Herpes simplex encephalitis (HSE) still has a poor outcome in a significant portion of patients. In severe cases of HSE, reduced carbon dioxide reactivity is usually present and these patients don't respond to the usual treatment of brain edema and intracranial hypertension. We present case series of patients with severe form of HSE treated with therapeutic hypothermia (TH) and describe in detail the indications, methods, and the rationale for its use. In this case series, patients presented with severely impaired consciousness and very high predicted death rate as measured by Glasgow coma scale and Acute Physiology and Chronic Health Evaluation (APACHE II) score respectively. According to our findings, TH in carefully selected patients with HSE holds promise as an adjunctive to the antiviral treatment.
authors.affiliation: Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases Dr. Fran Mihaljević, University of Zagreb School of Medicine, Mirogojska 8, 10000, Zagreb, Croatia. mkutlesa@bfm.hr
authors.forename: Marko
authors.initials: M
authors.lastname: Kutleša
authors.forename: Bruno
authors.initials: B
authors.lastname: Baršić
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D001929:Brain Edema / Q000175:diagnosis / Q000628:therapy; D002245:Carbon Dioxide / Q000097:blood; D018450:Disease Progression; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis / Q000628:therapy*; D004677:Encephalocele / Q000175:diagnosis / Q000628:therapy; D015600:Glasgow Coma Scale; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000473:pathology; D010092:Oximetry; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D000998:Antiviral Agents; D002245:Carbon Dioxide; D000212:Acyclovir