Herpes simplex encephalitis

Suggested Alternatives for Differential Diagnosis California encephalitis, eastern equine encephalitis, West Nile encephalitis, western equine encephalitis, herpes simplex encephalitis, meningitis, brain abscess, carcinomatous meningitis, CNS vasculitis, cerebrovascular disease. 

Vidarabine inhibits vitally induced DNA polymerase more strongly than it does the endogenous enzyme. Its use is now limited to topical treatment of severe herpes simplex infection. Before the introduction of the better tolerated acyclovir, vidarabine played a major part in the treatment of herpes simplex encephalitis. 

Herpes simplex encephalitis 10 mg/kg infused at a constant rate over at least 1 hour every 8 hours for 10 days 20 mg/kg infused at a constant rate over at least 1 hour every 8 hours for 10 days-... 

Rail up 10-50 x 10 ) Lyme meningopolyneuritis Herpes simplex encephalitis... 

IgA < 20%, IgM < 50% Herpes simplex encephalitis Neurosyphilis Chronic HIV encephalitis... 

Intravenous acyclovir is used in the treatment of herpes simplex encephalitis, neonatal HSV infection, and mucocutaneous HSV infection in immunocompromised individuals. Acyclovir ointment is used in the treatment of initial genital herpes but is not effective for recurrent disease. Ophthalmic acyclovir formulations, although not available in the United States, are effective in the treatment of herpes keratoconjunctivitis. 

Herpes simplex mucocutaneous IV 5 mg/kg/dose q8h for 7 days Herpes simplex encephalitis IV 10 mg/kg q8h for 10 days Herpes zoster (caused by varicella) IV 10 mg/kg q8h for 7 days. 

Intravenous acyclovir is the treatment of choice for herpes simplex encephalitis, neonatal HSV infection, and serious HSV or VZV infections (Table 49-1). In immunocompromised patients with VZV infection, intravenous acyclovir reduces the incidence of cutaneous and visceral dissemination. 

Indications PO - acute treatment of herpes zoster (shingles) Initial episodes and the management of genital herpes Treatment of chickenpox (varicella) IV - treatment of initial and recurrent mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) in immunocompromised patients Treatment of herpes simplex encephalitis Treatment of neonatal herpes infections Treatment of varicella-zoster (shingles) infections in immunocompromised patients... 

The antiviral activity of 322, determined351 using primary rabbit kidney cells injected with HS V-l (Herpes Simplex Virus type 1), showed that BVFRU has antiviral potency and transport characteristics suitable for in vivo diagnosis of HSE (Herpes Simplex Encephal-ities) because of greater stability of bromine-carbon bonds than iodine-carbon bond present in [131I]IVDU352, [( )-5-(2-iodovinyl)-l-(2-deoxy- -D-ribofuranosyl)uracil]. 

Comparison of survival in patients with biopsy-proved herpes simplex encephalitis treated with vidarabine or acyclovir... 

An immediately life-threatening disease means a stage of a disease in which there is a reasonable likelihood that death will occur within a matter of months, or in which premature death is likely without early treatment. For example, advanced cases of AIDS, herpes simplex encephalitis, and subarachnoid hemorrhage are all considered immediately life-threatening diseases. Treatment INDs are made available to patients before general marketing begins, typically... 

Hofgartner WT, Huhmer AF, Landers JP, Kant JA. Rapid diagnosis of herpes simplex encephalitis using microchip electrophoresis of PCR products. Clin Chem 1999 45 2120-2128. 

Desciibe the clinical features coimnonly associated with Herpes Simplex encephalitis. 

Yamada S, Kameyama T, Nagaya S, Hashizume Y, Yoshida M (2002) Relapsing herpes simplex encephalitis padiological confinnadon of viral reacdvation. J Neurol Neurosurg Psych 74 262-264. 

McGrath N, Anderson NE, Croxson MC, Powell KF (1997) Herpes simplex encephalitis treated with acyclovir Diagnosis and long term outcome. J Neurol Neurosurg Psych 63 321-326. 

Skoldenberg B (1991) Herpes simplex encephalitis. Scand J Infect Dis Suppl 80 40 6. 

The adverse effects of contrast agents during computed tomography (CT) are broadly similar to those during excretion urography, but the incidence of serious reactions and deaths may be higher, because reactions are harder to treat when the patient is in a scanner (SEDA-7, 451). Renal insufficiency can occur in patients with diabetes and pre-existing renal disease or as a result of multiple examinations. In Herpes simplex encephalitis. 

Aurelius E, Johansson B, Skoldenberg B, Staland A, Forsgren M. Rapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid. Lancet 1991 337 ... 

Lakeman F, Whitley RJ. Diagnosis of herpes simplex encephalitis Application of polyermase chain reaction to cerebrospinal fluid firom brain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. J Infect Dis 1995 171 857. 

Whitley RJ, Alford CA, Hirsch MS, Schooley RT, Luby JP, Aoki FY, et al. Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med 1986 314 144-9. 

Acyclovir is the drug of choice for herpes simplex encephalitis. In patients with normal renal function, acyclovir is usually administered as 10 mg/kg intravenously every 8 hours for 2 to 3 weeks. Herpes virus resistance to acyclovir has been reported with increasing incidence, particularly from immunocompromised patients with prior or chronic exposures to acyclovir. The alternative treatment for acyclovir-resistant herpes simplex virus is foscarnet. The major toxicity of foscarnet is renal impairment, and doses must be individualized for renal function. The dose for patients with normal renal function is 40 mg/kg infused over 1 hour every 8 to 12 hours for 2 to 3 weeks. Ensuring adequate hydration is imperative. In addition, patients receiving foscarnet should be monitored for seizures related to alterations in plasma electrolyte levels. 

HV antigen/Dako/1 1000 Herpes simplex encephalitis CMV herpes zoster None... 

Herpes simplex encephalitis Encephalitis (Table 20.2) Cowdry A amphophilic nuclear inclusions of 90-100 nm target capsids HSV Temporal or basilar frontal lobe(s) CNS frequently bilateral... 

Acyclovir is more effective the more serious the disease and the earlier it is given. It has been shown to be efficacious when used systemically in the prophylaxis of HSV infections in immunosuppressed patients, ie, bone marrow transplant recipients (67). Acyclovir therapy appears to be superior to ara-A in the treatment of herpes simplex encephalitis in humans (68). 

---