Herpesviral encephalitis

Herpesviral encephalitis

Herpesviral encephalitis is a viral infection of the brain caused primarily by the herpes simplex virus. It is a serious condition that can lead to severe neurological complications and even death if not promptly diagnosed and treated.

Etiology

Herpesviral encephalitis is most commonly caused by Herpes simplex virus-1 (HSV-1), but can also be caused by Herpes simplex virus-2 (HSV-2), and rarely, by Varicella-zoster virus (VZV), Epstein-Barr virus, and Cytomegalovirus. The virus is usually contracted through direct contact with the saliva, nasal secretions, or lesions of an infected individual.

Clinical Presentation

Patients with herpesviral encephalitis typically present with a sudden onset of fever, headache, seizures, and neurological deficits. Other symptoms may include nausea, vomiting, photophobia, and altered mental status. In severe cases, patients may develop coma.

Diagnosis

Diagnosis of herpesviral encephalitis is based on clinical presentation, lumbar puncture results, and neuroimaging studies. The definitive diagnosis is made by detecting HSV DNA in the cerebrospinal fluid (CSF) using polymerase chain reaction (PCR) testing.

Treatment

The mainstay of treatment for herpesviral encephalitis is antiviral therapy with acyclovir. Supportive care, including analgesics for pain and fever, anticonvulsants for seizures, and intravenous fluids for hydration, is also important.

Prognosis

The prognosis of herpesviral encephalitis depends on the severity of the disease and the timeliness of treatment. With early diagnosis and treatment, the mortality rate can be reduced to 20-30%. However, many survivors have long-term neurological sequelae.

Prevention

Prevention of herpesviral encephalitis involves avoiding contact with individuals with active herpes lesions and practicing good personal hygiene. There is currently no vaccine available for HSV-1 or HSV-2.