title: Primary herpes virus infection and ischemic stroke in childhood: a new association?
abstract: We describe, to our knowledge, the first case of arterial ischemic stroke after primary herpes simplex virus type 1 (HSV1) infection in a previously healthy child, without signs of encephalitis. A 10-year-old previously healthy girl was admitted to our hospital with acute left-sided hemiparesis which involved the lower half of her face. Submandibular lymphadenitis and oral vesicular lesions were present. MRI confirmed the suspicion of an acute ischemic stroke. Immunoglobulin M antibodies to HSV1 were detected. Cerebrospinal fluid polymerase chain reaction for herpes virus was negative. She was treated with aspirin (3mg/kg) and intravenous acyclovir (10mg/kg every 8 hours) for 21 days. Immunoglobulin G antibodies to HSV1 appeared 16 days after admission. Twelve months after her hospitalization the patient's examination was normal. Stroke should be considered a possible complication of HSV1 primary infection. Guidelines for the management of acute stroke in children are needed.
authors.affiliation: Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy. Electronic address: terlizzivito@libero.it.
authors.forename: Vito
authors.initials: V
authors.lastname: Terlizzi
authors.affiliation: Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Improta
authors.affiliation: Department of Pediatrics, S. Maria delle Grazie Pozzuoli Hospital, Naples, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Di Fraia
authors.affiliation: Department of Pediatrics, S. Maria delle Grazie Pozzuoli Hospital, Naples, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sanguigno
authors.affiliation: Unit of Neuroradiology, Department of Advanced Biomedical Sciences, University of Naples, Federico II, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: D'Amico
authors.affiliation: Neuroscience Department, "Santobono-Pausilipon" Children's Hospital, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Buono
authors.affiliation: Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Raia
authors.affiliation: Department of Pediatrics, S. Maria delle Grazie Pozzuoli Hospital, Naples, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Boccia
mesh_terms: D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000134:cerebrospinal fluid / Q000150:complications* / Q000276:immunology; D018259:Herpesvirus 1, Human; D006760:Hospitalization; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D020521:Stroke / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
keywords: Acyclovir; Children; Herpes virus; Infection; Stroke; Therapy; Vascular narrowing