García-Beristain JC, Barragán-Pérez E, Choperena-Rodriguez R

Language: Spanish
References: 7
Page: 126-132
PDF size: 205.31 Kb.

ABSTRACT

Introduction: Relapses in patients with HSV-1 infection frequently occurs by a viral reactivation which has been found in less than 25 % of adults and children studied, it has also been suggested that these relapses could involve immunologically-mediated mechanisms, some evidence that viral infections are associated with anti-NMDA antibodies in children and adults increases the possibility of induction of anti-NMDA during viral infection, and could be responsible for a second phase of immunologically-mediated encephalopathy.
Case report: A 13-year-old male with clinical course of viral encephalitis initially with fever, seizures and left hemiparesis confirmed by positive PCR for herpes simplex virus (HSV) type 1 in the cerebrospinal fluid (CSF), receiving antiviral treatment with exacerbation of symptoms 30 days later, with negativization of PCR, as well as the presence of anti-NMDA antibodies in CSF with good response to immunomodulatory therapy.
Conclusions: It is necessary to establish a diagnostic protocol to routinely search immunological etiologies in pediatric patients with encephalitis, as well as to establish the association of anti-NMDA with HSV infection, which could help to propose therapeutic regimens appropriate for these cases.

REFERENCES

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