A 29-year-old person comes with focal seizures. MRI shows frontal and temporal enhancement. What is the most probable diagnosis?
§In children and young adults primary HSV infection can led to encephalitis, by neurotropic spread of virus from periphery via olfactory bulb.
§In other majority of cases, there is prior mucocutaneous HSV-1 infection which gets reactivated.
§Clincial hallmark of HSV infection include acute onset of fever, and focal neurological symptoms and signs, especially of temporal lobe.
Diagnosis :
§CSF protein and CSF lymphocytosis §Brain biopsy is gold standard
§HSV DNA detection in CSF by PCR has largely replaced biopsy
Treatment : IV acyclovir
Meningococcal meningitis
Herpes simplex encephalitis
Japanese encephalitis
Enterovirus encephalitis