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Managing atypical and typical herpetic central nervous system infections: results of a multinational study
Y. Cag, H. Erdem, S. Leib, S. Defres, S. Kaya, L. Larsen, M. Poljak, D. Ozturk-Engin, B. Barsic, X. Argemi, SM. Sørensen, AL. Bohr, P. Tattevin, JD. Gunst, L. Baštáková, M. Jereb, IS. Johansen, O. Karabay, AU. Pekok, OR. Sipahi, M. Chehri, G....
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
- MeSH
- Diagnostic Tests, Routine MeSH
- DNA, Viral analysis genetics MeSH
- Adult MeSH
- Electroencephalography MeSH
- Encephalitis, Herpes Simplex diagnosis therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Adolescent MeSH
- Young Adult MeSH
- Brain diagnostic imaging MeSH
- Cerebrospinal Fluid virology MeSH
- Polymerase Chain Reaction MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
There have been many studies pertaining to the management of herpetic meningoencephalitis (HME), but the majority of them have focussed on virologically unconfirmed cases or included only small sample sizes. We have conducted a multicentre study aimed at providing management strategies for HME. Overall, 501 adult patients with PCR-proven HME were included retrospectively from 35 referral centres in 10 countries; 496 patients were found to be eligible for the analysis. Cerebrospinal fluid (CSF) analysis using a PCR assay yielded herpes simplex virus (HSV)-1 DNA in 351 patients (70.8%), HSV-2 DNA in 83 patients (16.7%) and undefined HSV DNA type in 62 patients (12.5%). A total of 379 patients (76.4%) had at least one of the specified characteristics of encephalitis, and we placed these patients into the encephalitis presentation group. The remaining 117 patients (23.6%) had none of these findings, and these patients were placed in the nonencephalitis presentation group. Abnormalities suggestive of encephalitis were detected in magnetic resonance imaging (MRI) in 83.9% of the patients and in electroencephalography (EEG) in 91.0% of patients in the encephalitis presentation group. In the nonencephalitis presentation group, MRI and EEG data were suggestive of encephalitis in 33.3 and 61.9% of patients, respectively. However, the concomitant use of MRI and EEG indicated encephalitis in 96.3 and 87.5% of the cases with and without encephalitic clinical presentation, respectively. Considering the subtle nature of HME, CSF HSV PCR, EEG and MRI data should be collected for all patients with a central nervous system infection.
Aalborg University Hospital Department of Infectious Diseases Denmark
Aarhus University Hospital Department of Infectious Diseases Aarhus Denmark
American University of Beirut Medical Center Beirut Lebanon
Assiut University Hospital Department of Neurology and Psychiatry Assiut Egypt
Bezmi Alem Vakif University School of Medicine Department of Neurology Istanbul Turkey
Department of Neurology Baghdad Teaching Hospital Iraq
Gulhane Medical Academy Department of Infectious Diseases and Clinical Microbiology Ankara Turkey
Haydarpasa Numune Training and Research Hospital Department of Neurology Turkey
Haydarpasa Numune Training and Research Hospital Department of Radiology Turkey
Hvidovre Hospital Department of Infectious Diseases Copenhagen Denmark
Institute for Infectious Diseases University of Bern Switzerland
Institute of Infection and Global Health University of Liverpool United Kingdom
Nouvel Hôpital Civil Department of Infectious Diseases Strasbourg France
Odense University Hospital Department of Infectious Diseases Q Odense Denmark
Poitiers University Hospital Department of Infectious Diseases France
Private Umit Hospital Department of Infectious Diseases and Clinical Microbiology Eskisehir Turkey
University Hospital of Pontchaillou Department of Infectious and Tropical Diseases Rennes France
University Medical Centre Department of Infectious Diseases Ljubljana Slovenia
References provided by Crossref.org
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- $a Managing atypical and typical herpetic central nervous system infections: results of a multinational study / $c Y. Cag, H. Erdem, S. Leib, S. Defres, S. Kaya, L. Larsen, M. Poljak, D. Ozturk-Engin, B. Barsic, X. Argemi, SM. Sørensen, AL. Bohr, P. Tattevin, JD. Gunst, L. Baštáková, M. Jereb, IS. Johansen, O. Karabay, AU. Pekok, OR. Sipahi, M. Chehri, G. Beraud, G. Shehata, R. Fontana, M. Maresca, H. Karsen, G. Sengoz, M. Sunbul, G. Yilmaz, H. Yilmaz, A. Sharif-Yakan, S. Kanj, E. Parlak, F. Pehlivanoglu, F. Korkmaz, S. Komur, S. Kose, M. Ulug, S. Bolukcu, SA. Coskuner, JP. Stahl, N. Ince, Y. Akkoyunlu, G. Halac, E. Sahin-Horasan, H. Tireli, G. Kilicoglu, A. Al-Mahdawi, SA. Nemli, A. Inan, S. Senbayrak, H. Vahaboglu, N. Elaldi,
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