Article Text

HERPES SIMPLEX ENCEPHALITIS IN CHILDREN YOUNGER THAN TWO YEARS
  1. E Jamroz1,
  2. J Surmik1,
  3. J Paprocka1,
  4. E Kuleta-Bosak2,
  5. P Surmiak3,
  6. M Dubiel3
  1. 1Neuropediatrics Department, Silesian Medical University, Katowice, Poland
  2. 2Department Of Radiology And Nuclear Medicine, Silesian Medical University, Katowice, Poland
  3. 3Neuropediatrics Student’s Scientific Associasion, Silesian Medical University, Katowice, Poland

Abstract

Herpes simplex encephalitis (HSE) still remains a severe central nervous system infection, leaving neurologic sequeles, despite the use of acyclovir therapy significantly decreasing its mortality and morbility.

Aim Clinical analysis of patients diagnosed with HSE younger then 2 years old.

Methods The analyzed group consist of 10 patients (6 males and 4 females) aged between 5 weeks to 11 months hospitalized in 1999–2007. The diagnosis was based on the clinical presentation, neuroimagining (CT, MRI), laboratory findings (the cerebrospinal fluid analyses, detection of anti-HSV antibodies, polymerase chain reaction) and electroencephalography.

Results In most patients authors reported the symptoms typical for neuroinfections: fever, vomiting, altered consciousness, and 8 children presented with convulsions (partial, generalized tonic-clonic, myoclonic). In the physical examination one child had labial herpes (two had contact with visibly infected persons). In the neurological examination the most common finding was hemiparesis. Neuroimaging (MRI or CT) revealed abnormalities of different extents in all analyzed patients. Laboratory finding confirmed herpes etiology by positive PCR results or presence of IgG and IgM antibody in serum or cerebral spinal fluid. In all the children acyclovir therapy was conducted. Only in one patient was relapse of herpes encephalities observed.

Conclusions The right diagnosis and early antiviral treatment is an important factor in remission of clinical symptoms and is crucial for good outcome.

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