Herpes Simplex Virus Encephalitis in a Post-operative Case of Follicular Thyroid Carcinoma.

Discoveries (Craiova, Romania) Pub Date : 2024-09-30 eCollection Date: 2024-07-01 DOI:10.15190/d.2024.13
Anuragani Verma, Shruti Radera, Amita Jain, Nandini Mishra, Sheetal Agarwal, Om Prakash
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Abstract

Herpes simplex virus (HSV) encephalitis is a life-threatening consequence of HSV infection of the central nervous system. Early antiviral therapy is most effective, necessitating prompt diagnosis. We report a case of atypical HSV encephalitis. The appearance of a strong headache followed by impairment of consciousness during the postoperative course in a 70-year-old patient who underwent surgical removal of a follicular thyroid carcinoma. Diffusion-weighted MRI detected brain abnormalities on the second day after the onset of symptoms, and polymerase chain reaction identification of HSV-1 DNA confirmed the diagnosis. A positive prognosis was achieved due to the decision to start specific, high-dose antiviral therapy based on clinical suspicion. A firm diagnosis was established by Tzanck smear and polymerase chain reaction.

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滤泡性甲状腺癌术后单纯疱疹病毒性脑炎1例。
单纯疱疹病毒(HSV)脑炎是HSV感染中枢神经系统的一种危及生命的后果。早期抗病毒治疗最有效,需要及时诊断。我们报告一例非典型HSV脑炎。一例70岁的甲状腺滤泡癌手术切除患者术后出现强烈头痛并伴有意识障碍。症状出现后第二天,弥散加权MRI检测到脑部异常,HSV-1 DNA聚合酶链反应鉴定证实了诊断。由于基于临床怀疑决定开始特异性高剂量抗病毒治疗,预后良好。经Tzanck涂片和聚合酶链反应确诊。
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