Herpes simplex encephalitis: A new type of "ICU-acquired infection"?

Electrophysiology Herpes simplex Encephalitis Herpes simplex reactivation ICU acquired Infection Immunosuppression Infectious disease Intensive care Intensive care medicine Neurology Neurosurgery

Journal

Heliyon
ISSN: 2405-8440
Titre abrégé: Heliyon
Pays: England
ID NLM: 101672560

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 29 12 2019
revised: 17 03 2020
accepted: 23 03 2020
entrez: 8 4 2020
pubmed: 8 4 2020
medline: 8 4 2020
Statut: epublish

Résumé

Although it is a well-known disease, the occurrence of Clinical observation of one patient. An 87-year-old male was admitted to the Intensive Care Unit (ICU) because of respiratory failure due to an exacerbation of myasthenia gravis. After corticoids and azathioprine treatment, his clinical condition improved, allowing weaning from mechanical ventilation. One month after admission, while still hospitalized in the ICU, the patient developed fever and confusion. In the context of confounding factors, HSE was not suspected before a convulsive status epilepticus occurred, resulting in a significant delay in treatment. Diagnosis was confirmed by PCR-analysis in the cerebrospinal fluid. Serological status confirmed reactivation of prior herpes simplex infection. The patient died one week after the onset of confusion. Hospital-"acquired" HSE must be suspected in case of new neurologic symptoms associated with fever, even in ICU-hospitalized patients. The diagnosis is made even more difficult by nonspecific symptoms due to previous diseases, leading to an even more severe prognosis in those vulnerable patients.

Identifiants

pubmed: 32258496
doi: 10.1016/j.heliyon.2020.e03667
pii: S2405-8440(20)30512-0
pii: e03667
pmc: PMC7113434
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e03667

Informations de copyright

© 2020 Published by Elsevier Ltd.

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Auteurs

Fabien Hauw (F)

Neuro-Intensive Care Unit, Fondation Rothschild, 29 rue Manin, 75019 Paris, France.

Vera Dinkelacker (V)

Department of Neurology, Fondation Rothschild, 29 rue Manin, 75019 Paris, France.

Pierre Jaquet (P)

Intensive Care Unit, Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris 47-85 Bd de l'Hôpital 75013 Paris, France.

Hervé Vespignani (H)

Serenity Medical Services - NeuroPhy, ICM-iPEPS, 47-85 Bd de l'Hôpital, 75013 Paris, France1http://www.serenitymedicalservices.com.

Charles Grégoire (C)

Neuro-Intensive Care Unit, Fondation Rothschild, 29 rue Manin, 75019 Paris, France.

Mathilde Perrin (M)

Neuro-Intensive Care Unit, Fondation Rothschild, 29 rue Manin, 75019 Paris, France.

Nicolas Engrand (N)

Neuro-Intensive Care Unit, Fondation Rothschild, 29 rue Manin, 75019 Paris, France.

Classifications MeSH