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: 84.048
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
Peculiar case of herpetic viral encephalitis
S.-M. Draghici 1 , N. Negrut 1 , A. csep 1 , I. zaporojan 2 , M. Petric 1
1 University of Oradea, Oradea, Romania, 2 Hospital of Pneumophtysiology, Oradea, Romania
Background: Herpetic viral encephalitis is a severe disease, especially in neonates and
immunocompromised hosts. HSE with HSV 2 appears more frequently in persons younger than
20 and older than 50. Immunossupresion may be the cause of herpes simplex viral encephalitis.
Methods: The case presentation is supported by the information found in this patient’s files from
three medical services where he was admitted: Clinic of Internal Medicine, Neurosurgery, and
finally Clinic of Infectious Diseases of the University of Oradea.
Results: A 16 years old rural male patient, presented starting with September 2009 headaches,
night sweating, lack of appetite, vomiting, abdominal pain, diarrhea and weight loss, diagnosed as
digestive disorder. In October 2009 he was sent to the Clinic of Neurosurgery for persistent
headaches, fever, paresthesia of the upper limbs, with the suspicion of a cerebral tumor. At the
admission into the hospital, a massive elimination of round worms was observed in his feces.
Physical examination revealed tremor of the upper limbs, herpetic vesicles in the genital area and
hepatomegaly. The patient declared that he had recently started his sexual life.
Cell blood count and CSF analysis were normal. Cerebral CT revealed a hypodense area in the
right frontal lobe and MRI indicated a possible viral/parasites encephalitis. Serological test was
positive for HSV 2 IgM antibodies (14.5 UI) and negative for HSV 2 IgG antibodies. Stool test was
positive for Enterobius vermicularis and Giardia lamblia. The patient was transferred to the Clinic
of Infectious Diseases. Treatment with Acyclovir 10 mg/kg i.v. was started for 14 days, every 8
hours, associated with Manitol, neurotrophic drugs, and vitamins. The patient was also
administered Albendazol 400 mg b.i.d for 14 days, repeated 3 times. The evolution was
favorable, without complications.
Conclusion: HSE with HSV type 2 is a rare condition. Localization in the frontal lobe is
infrequent, with the lesions usually occurring in temporal lobes; CBC and CSF in normal range
are also rare for HSE. The association with enterobiasis and lambliasis might have produced the
immunodepression in our case, other favorizing factors being pubescent age, and the debut of
sexual life.