Indian Journal of Dermatology
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CASE REPORT
Year : 2011  |  Volume : 56  |  Issue : 6  |  Page : 749-751

Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy


1 Department of Pediatrics, Alain Hospital-affiliate to Medical University of Vienna, Alain, United Arab Emirates
2 Department of General Medicine Hospital, Jagadhri, Yamunanagar, Haryana, India

Correspondence Address:
Ratna B Basak
Brookdale University Hospital and Medical Center, 1 Brookdale Plaza, Brooklyn, NY
United Arab Emirates
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.91846

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A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV) type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.


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