Corticosteroids in herpes simplex virus encephalitis
- Departments of Neurology and Virology, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
- Correspondence to: Dr Harry Openshaw City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA;
The effectiveness of corticosteroids in herpes simplex virus encephalitis is not proven
Despite receiving standard antiviral therapy, an appreciable number of patients with herpes simplex virus encephalitis (HSVE) experience poor acute outcome or delayed neurological progression. It is uncertain whether all poor outcomes are due to viral cytopathology or whether an immune mediated pathogenesis also occurs. In support of an immunopathological cause, Kamei et al (see pages XX–XX of this issue) report that corticosteroid administration was a significant predictor of favourable outcome at 3 months after HSVE infection.
Immune cells persist and elaborate cytokines in the nervous system long after the virus has entered latency.1 It is …