An Unusual Presentation of Herpes Simplex Virus Encephalitis

We present a case of a 65-year-old man with an acute alteration in mental state that was initially diagnosed as a functional psychiatric condition. After extensive workup, herpes simplex virus type 1 (HSV-1) was detected in the patient’s cerebrospinal fluid (CSF) by polymerase chain reaction (PCR),...

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Main Authors: Ray Boyapati, George Papadopoulos, James Olver, Michael Geluk, Paul D. R. Johnson
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2012/241710
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author Ray Boyapati
George Papadopoulos
James Olver
Michael Geluk
Paul D. R. Johnson
author_facet Ray Boyapati
George Papadopoulos
James Olver
Michael Geluk
Paul D. R. Johnson
author_sort Ray Boyapati
collection DOAJ
description We present a case of a 65-year-old man with an acute alteration in mental state that was initially diagnosed as a functional psychiatric condition. After extensive workup, herpes simplex virus type 1 (HSV-1) was detected in the patient’s cerebrospinal fluid (CSF) by polymerase chain reaction (PCR), and he responded rapidly to treatment with acyclovir. The case illustrates the importance of actively excluding organic causes in such patients, the need to have a low threshold of suspicion for HSV encephalitis, and the central role of CSF PCR testing for the diagnosis of HSV encephalitis, even in the absence of CSF biochemical abnormalities.
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spelling doaj-art-233adb071b0b4a44a4ff67ca40d68f582025-08-20T02:04:37ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/241710241710An Unusual Presentation of Herpes Simplex Virus EncephalitisRay Boyapati0George Papadopoulos1James Olver2Michael Geluk3Paul D. R. Johnson4Department of Medicine, Austin Health, Studley Road, Heidelberg, VIC 3084, AustraliaDepartment of Medicine, Austin Health, Studley Road, Heidelberg, VIC 3084, AustraliaDepartment of Psychiatry, Austin Health, Studley Road, Heidelberg, VIC 3084, AustraliaDepartment of Emergency Medicine, Austin Health, Studley Road, Heidelberg, VIC 3084, AustraliaDepartments of Infectious Diseases and Microbiology, Austin Health, Studley Road, Heidelberg, VIC 3084, AustraliaWe present a case of a 65-year-old man with an acute alteration in mental state that was initially diagnosed as a functional psychiatric condition. After extensive workup, herpes simplex virus type 1 (HSV-1) was detected in the patient’s cerebrospinal fluid (CSF) by polymerase chain reaction (PCR), and he responded rapidly to treatment with acyclovir. The case illustrates the importance of actively excluding organic causes in such patients, the need to have a low threshold of suspicion for HSV encephalitis, and the central role of CSF PCR testing for the diagnosis of HSV encephalitis, even in the absence of CSF biochemical abnormalities.http://dx.doi.org/10.1155/2012/241710
spellingShingle Ray Boyapati
George Papadopoulos
James Olver
Michael Geluk
Paul D. R. Johnson
An Unusual Presentation of Herpes Simplex Virus Encephalitis
Case Reports in Medicine
title An Unusual Presentation of Herpes Simplex Virus Encephalitis
title_full An Unusual Presentation of Herpes Simplex Virus Encephalitis
title_fullStr An Unusual Presentation of Herpes Simplex Virus Encephalitis
title_full_unstemmed An Unusual Presentation of Herpes Simplex Virus Encephalitis
title_short An Unusual Presentation of Herpes Simplex Virus Encephalitis
title_sort unusual presentation of herpes simplex virus encephalitis
url http://dx.doi.org/10.1155/2012/241710
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