Victoria Aramă *, Atena Negoiţă **, Georgeta Popa ***, Adriana Hristea ****, Raluca Sandu ****, M. Ştocan *****
* Dr. Victoria Aramă – șef de lucrări, UMF “Carol Davila” Bucureşti; medic primar Institutul de Boli Infecţioase “Prof. Dr. Matei Balş” Bucureşti
** Dr. Atena Negoiţă — Medic rezident anul V, Institutul de Boli Infecţioase “Prof. Dr. Matei Balş” Bucureşti
*** Dr Georgeta Popa — medic primar radiologie-imagistică medicală, Institutul de Boli Infecţioase “Prof. Dr. Matei Balş” Bucureşti
**** Dr. Adriana Hristea – Sef de lucrări, UMF “Carol Davila” Bucureşti; medic primar Boli Infecţioase “Prof. Dr. Matei Balş” Bucureşti
***** Dr. Raluca Sandu — Medic rezident anul IV, Institutul de Boli Infecţioase “Prof. Dr. Matei Balş” Bucureşti
****** Dr Mihai Stocan — medic rezident anul V, Clinica Medicală – Spitalul Militar Central Bucureşti
Abstract
Herpes simplex encephalitis is the most frequent viral infection of central nervous system. HSV1 generates a fo cal, pseudotumoral (temporal lobe), encephalitis with a high mortality in spite of a correct treatment with acyclovir. HSV2 usually generates aseptic (lymphocytic), benign meningitis, which could be recurrent (Mollaret meningitis). In two thirds of cases, HE is produced by reactivation of endogen, latent HSV1 infection. HSV2 is the etiological factor of neonatal HE in two thirds of cases. The clinical manifestations are similar for all tipes of viral encephalities. Nowadays, the detection of HSV-DNA by CSF PCR represents the reference method of the etiological diagnosis of HE. This technique has allowed a prompt diagnosis and treatment and has already reduced the mortality. The election therapy is intravenous acyclovir, 1O mg/ kg/8h, 14-21 days. The control of treatment efficacy could be made by detection of HSV-DNA in CSF. As HE is still associated with a high mortality and a great risk of definitive neurological sequela, the herpes simplex etiology must be taken into account in every case of viral encephalitis. Most authors recommand acyclovir as an empirical therapy which may be sloped if herpetic ethiology is negative.