Abstract
It is unclear whether immunosuppression is a risk factor for herpes encephalitis. Herein, we describe a rare case of herpes simplex virus type 2 encephalitis in a patient treated with low-dose methotrexate for HLA-B27-associated spondyloarthritis. The patient was successfully treated with acyclovir but presented sequelae of encephalitis. Here we discuss the possible role of low-dose methotrexate therapy as a risk factor of neurological herpes reactivation and severe disease. The host-related and viral risk factors are also addressed.
MeSH terms
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Acyclovir / therapeutic use*
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Aged
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Antiviral Agents / therapeutic use*
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Contraindications, Drug
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Encephalitis, Herpes Simplex / drug therapy*
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Encephalitis, Herpes Simplex / etiology
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Encephalitis, Herpes Simplex / immunology
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Encephalitis, Herpes Simplex / pathology
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Gene Expression
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HLA-B27 Antigen / genetics
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HLA-B27 Antigen / immunology
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Humans
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Immunosuppressive Agents / adverse effects*
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Male
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Methotrexate / adverse effects*
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Risk Factors
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Spondylitis, Ankylosing / drug therapy*
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Spondylitis, Ankylosing / immunology
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Spondylitis, Ankylosing / pathology
Substances
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Antiviral Agents
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HLA-B27 Antigen
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Immunosuppressive Agents
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Acyclovir
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Methotrexate