title: Pediatric herpes simplex virus encephalitis: a retrospective multicenter experience.
abstract: Knowledge on pediatric herpes simplex virus encephalitis is limited. Here we summarize 6 neonates and 32 children diagnosed by polymerase chain reaction (n = 37) or serological studies (n = 1), respectively. Diagnosis was difficult, as only 15 patients presented neurologic symptoms. Moreover, cerebrospinal fluid glucose, protein, and leukocytes were normal in 6 patients. Subsequently, all but 2 showed neurologic symptoms. Diffusion-weighted neuroimaging was the most sensitive early imaging method. Despite acyclovir treatment, 8 patients experienced early relapses, showing movement abnormalities, impaired vigilance, and seizures. Diffuse white matter changes, found in 3 of 5 relapse patients on neuroimaging, and a negative cerebrospinal fluid herpes simplex virus polymerase chain reaction suggested inflammatory processes. All relapse patients were again treated with acyclovir, and 3 responded to additional corticosteroid treatment. Whereas outcome after relapses was poor, overall outcome was good. No child died; 14 were asymptomatic at discharge, and neuroimaging remained normal in 7 of 30 patients studied.
authors: Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany. Lena.Schleede@rwth-aachen.de
authors: Lena
authors: L
authors: Schleede
authors: Wolfgang
authors: W
authors: Bueter
authors: Sara
authors: S
authors: Baumgartner-Sigl
authors: Thomas
authors: T
authors: Opladen
authors: Katharina
authors: K
authors: Weigt-Usinger
authors: Susanne
authors: S
authors: Stephan
authors: Martin
authors: M
authors: Smitka
authors: Steffen
authors: S
authors: Leiz
authors: Olaf
authors: O
authors: Kaiser
authors: Verena
authors: V
authors: Kraus
authors: Andreas
authors: A
authors: van Baalen
authors: Heino
authors: H
authors: Skopnik
authors: Hans
authors: H
authors: Hartmann
authors: Kevin
authors: K
authors: Rostasy
authors: Thomas
authors: T
authors: Lücke
authors: Ulrike
authors: U
authors: Schara
authors: Martin
authors: M
authors: Häusler
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology / Q000821:virology*; D011446:Prospective Studies; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D018139:Simplexvirus / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir