14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
is available electronically on http://www.sciencedirect.com
Final Abstract Number: 84.013
Session: Virology and Viral Infections (Non-HIV)
Date: Friday, March 12, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Diagnostic criteria for Herpes simplex encephalitis: 5 year analysis in Mofid Children’s Hospital
A. Karimi 1 , M. Hadipour jahromy 2 , S. tabatabaei 3
1 Pediatric infectious Research disease, Tehran, Iran, Islamic Republic of, 2 Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of, 3 PIRC, tehran, Iran, Islamic
Republic of
Background: To define the criteria for diagnosis of Herpes Simplex Encephalitis, (HSE), in
children.
Methods: Charts of all patients, admitted to Mofid Children’s Hospital in Tehran, Iran, from 1999
to 2005, with clinically suspected Herpes Simplex Encephalitis or meningo-encephalitis were
reviewed. We documented relevant variables, including demographic data, signs and symptoms
at presentation, and laboratory investigations such as CSF analysis, PCR and the results of
neuro-imaging. Patients were categorized into three groups according to the diagnosis of HSE
being definite, probable or possible. Diagnosis was defined as ‘definite’ in the presence of clinical
symptoms compatible with HSE and detection of the pathogen, or antigen-detection from the
cerebrospinal fluid by PCR. Diagnosis was designated as ‘probable’ in the presence of clinical
symptoms of HSE and abnormal analysis of CSF, or abnormalities in neuro-imaging compatible
with HSV infection.
Clinical symptoms compatible with HSE with normal CSF, or clinical manifestations not
characteristic of HSV infection but with abnormal analysis of CSF, were placed in the category of
‘possible’ HSE.
Results: According to above criteria, definite HSE was diagnosed in seven; probable HSE in
nine, and possible HSE in two patients.
Conclusion: We think every patient who has encephalitis with symptoms suggestive of HSE,
should be graded into one of the following diagnostic categories: definite, probable, or possible
HSE; otherwise the diagnosis should be rejected. This classification would help the clinician in
decision-making as regards treatment with Acyclovir. We recommend a multicenter
epidemiological study to confirm the efficacy of these criteria.