Imaging and laboratory investigation in herpes simplex encephalitis
- aDepartment of Paediatrics, Hillingdon Hospital, Pield Heath Road, Uxbridge, Middx UB8 3NN, UK, bDepartment of Paediatrics, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK, cProtein Reference Unit, Department of Immunology, St. Georges Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK, dDepartment of Neurochemistry, Institute of Neurology, Queen Square, London WCIN 3BG, UK
- Dr M E Coren, Department of Paediatrics, St Mary’s Hospital, Praed Street, London W2 1NY, UK.
- Received 24 August 1998
- Revised 5 February 1999
- Accepted 5 March 1999
A 14 day old baby presented with signs of an acute encephalitis. Clinically, herpes simplex encephalitis (HSE) was suspected. Early MRI and EEG were normal and there was rapid clinical improvement. A negative polymerase chain reaction (PCR) result on the initial CSF sample seemed to make HSE most unlikely. This diagnosis was subsequently proved after demonstration of specific antibody production using immunoelectrophoresis of the CSF. The child had extensive damage to brain tissue. The need for sequential analysis of CSF in making or refuting this diagnosis is illustrated.