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Atypical manifestations and poor outcome of herpes simplex encephalitis in the immunocompromised

Neurology, 12/10/2012

Tan IL et al. – Immunocompromised states may predispose to HSE with atypical clinical and neuroradiologic features. Immunocompromised individuals with HSE have significantly worse outcomes and mortality. Early diagnosis and treatment is associated with improved outcome. The findings are particularly important in light of the increasing use of potent immunosuppressive and immunomodulatory therapies.

Avindra Nath (12/10/2012) comments:

The findings indicate that the index of suspicion for herpes simplex encephalitis should be high in patients with any underlying immunosuppression despite the lack of typical findings on MRI. Early treatment is key to prevent long term neurological deficits.

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