Diagnosis and surveillance of herpes simplex virus infection of the central nervous system

J Med Virol. 2000 Aug;61(4):468-73. doi: 10.1002/1096-9071(200008)61:4<468::aid-jmv9>3.0.co;2-9.

Abstract

Herpes simplex viruses (HSV) are responsible for neurological disorders that require rapid diagnostic methods and specific antiviral therapy. During 1997, 1431 cerebrospinal fluid samples (CSF) collected from 1339 patients with neurological disorder presentations were processed for HSV detection. Eleven patients were positive for HSV, seven presenting with encephalitis (6/7 due to HSV1) and 4 with aseptic meningitis (4/4 due to HSV2). The incidence of HSV encephalitis was 2.33 cases / 10(6) inhabitants/year. Among encephalitis (HSV encephalitis) cases, 1 patient died due to the late implementation of antiviral therapy, and sequelae were observed in 4 cases. No sequelae were observed in aseptic meningitis cases. Four HSV encephalitis cases were monitored by PCR detection in CSF. Despite acyclovir therapy, PCR remained positive in CSF up to 20 days in 2 cases. This result suggest that the antiviral treatment for HSV encephalitis should be monitored by PCR detection of HSV in CSF.

MeSH terms

  • Acyclovir / therapeutic use
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Central Nervous System Infections / drug therapy
  • Central Nervous System Infections / virology*
  • Cerebrospinal Fluid / virology
  • Child
  • Child, Preschool
  • DNA, Viral / cerebrospinal fluid
  • Encephalitis / epidemiology
  • Encephalitis / virology
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Herpes Simplex / drug therapy
  • Herpes Simplex / virology*
  • Herpesvirus 1, Human / genetics
  • Herpesvirus 1, Human / isolation & purification*
  • Herpesvirus 2, Human / genetics
  • Herpesvirus 2, Human / isolation & purification*
  • Humans
  • Incidence
  • Infant
  • Male
  • Meningitis, Aseptic / epidemiology
  • Meningitis, Aseptic / virology
  • Middle Aged
  • Polymerase Chain Reaction

Substances

  • Antiviral Agents
  • DNA, Viral
  • Acyclovir