Key result
A 19-year-old female with herpes simplex encephalitis experienced severe clinical deterioration despite early standard acyclovir therapy, requiring high-dose acyclovir, foscarnet, and steroids.
Case Report (n=1)
No
This case highlights a fulminant presentation of Herpes Simplex Virus Type I Encephalitis requiring aggressive unconventional long-term antiviral therapy including high-dose acyclovir, foscarnet, and corticosteroids.
Morbidity and mortality in HSE remain high despite antiviral advances; leaves open need for adjunctive strategies in prospective studies.
Herpes simplex-1 virus encephalitis (HSE) is the most commonly recognized cause of sporadic encephalitis in the United States. Historically HSE has been considered extremely detrimental given the associated relentless neurological deterioration secondary to cerebral edema and status epilepticus. With recent advances in antiviral therapeutics in past decades, the majority of complications can be managed effectively although the associated morbidity and mortality still remains high. The key modifiable factor determining recovery is the rapid initiation of antiviral therapy. We discuss the case of a 19-year-old female with HSE who received standard acyclovir therapy. Despite using recommended dosage and duration of acyclovir, her clinical condition worsened significantly and subsequently required multiple antiviral therapeutics and steroid therapy.
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Katyal et al. (2018) conducted a case report in Herpes Simplex Virus Type I Encephalitis (n=1). Acyclovir, Foscarnet, and Methylprednisolone was evaluated. A 19-year-old female with herpes simplex encephalitis experienced severe clinical deterioration despite early standard acyclovir therapy, requiring high-dose acyclovir, foscarnet, and steroids.
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