Reactivation and centripetal spread of herpes simplex virus complicating acoustic neuroma resection

Surg Neurol. 2009 Nov;72(5):502-4. doi: 10.1016/j.surneu.2008.11.002. Epub 2009 Jul 23.

Abstract

Background: Herpes simplex is a common human pathogen that has rare but severe manifestations including encephalitis.

Case description: A 44-year-old man underwent uneventful resection of an acoustic neuroma. Postoperatively, he developed swinging pyrexia, vomiting, and episodic confusion. Analysis of cerebrospinal fluid showed a lymphocytosis, and polymerase chain reaction revealed herpes simplex DNA. After treatment of herpes encephalitis with acyclovir, the patient made a good recovery.

Conclusion: Herpes encephalitis is a rare complication of neurosurgical procedures, and the most likely etiology is reactivation of latent infection from manipulation of cranial nerves.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Adult
  • Antiviral Agents / therapeutic use
  • Consciousness Disorders / virology
  • DNA, Viral / analysis
  • Encephalitis, Herpes Simplex / etiology*
  • Encephalitis, Herpes Simplex / physiopathology
  • Encephalitis, Herpes Simplex / virology
  • Facial Nerve / surgery
  • Facial Nerve / virology
  • Facial Nerve Diseases / complications*
  • Facial Nerve Diseases / virology
  • Fever / virology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neuroma, Acoustic / complications*
  • Neuroma, Acoustic / pathology
  • Neuroma, Acoustic / surgery*
  • Neurosurgical Procedures / adverse effects*
  • Neurosurgical Procedures / methods
  • Recurrence
  • Simplexvirus / genetics*
  • Tomography, X-Ray Computed
  • Vestibulocochlear Nerve / diagnostic imaging
  • Vestibulocochlear Nerve / pathology
  • Vestibulocochlear Nerve / surgery
  • Vomiting / virology

Substances

  • Antiviral Agents
  • DNA, Viral
  • Acyclovir