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HSV-1 encephalitis relapse after epilepsy surgery: a case report and review of the literature

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Abstract

Herpes simplex encephalitis relapses have been rarely reported, with only few cases occurring after neurosurgical interventions. A young man presented a late herpes simplex encephalitis relapse after left antero-mesial temporal resection for his refractory temporal lobe epilepsy. Eight days after surgery, he developed fever and aphasia. CSF PCR revealed more than 12,000 copies/ml of HSV-1 DNA. Intravenous acyclovir was immediately started with a complete recovery. Postoperative herpes simplex encephalitis can occur as primary infection or as relapse of previous infection. Surgical manipulation of brain parenchyma in the site of a previous infection can act as a trigger for viral reactivation. Early onset of antiviral therapy is fundamental and it is a strong predictor of clinical outcome. Despite no studies on prophylactic treatment with acyclovir in patients with previous herpes simplex encephalitis candidate to neurosurgery are available, we suggest that prophylactic treatment should be recommended.

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References

  • Aldea S, Joly L-M, Roujeau T, Oswald A-M, Devaux B (2003) Postoperative herpes simplex virus encephalitis after neurosurgery: case report and review of the literature. Clin Infect Dis 36:e96–e99

    Article  Google Scholar 

  • Alonso-Vanegas MA, Quintero-López E, Martínez-Albarrán AA, Moreira-Holguín JC (2016) Recurrent herpes simplex virus encephalitis after neurologic surgery. World Neurosurg 89:731

    Article  Google Scholar 

  • Bourgeois M, Vinikoff L, Lellouch-Tubiana A, Sainte-Rose C (1999) Reactivation of herpes virus after surgery for epilepsy in a pediatric patient with mesial temporal sclerosis: case report. Neurosurgery 44:633–635

    Article  CAS  Google Scholar 

  • De Tiège X, Rozenberg F, Des Portes V et al (2003) Herpes simplex encephalitis relapses in children: differentiation of two neurologic entities. Neurology 61:241–243

    Article  Google Scholar 

  • Fearnside MR, Grant JM (1972) Acute necrotizing encephalitis complicating bifrontal craniotomy and pituitary curettage. Report of two cases. J Neurosurg 36:499–502

    Article  CAS  Google Scholar 

  • Filipo R, Attanasio G, De Seta E, Viccaro M (2005) Post-operative herpes simplex virus encephalitis after surgical resection of acoustic neuroma: a case report. J Laryngol Otol 119:558–560

    Article  Google Scholar 

  • Gnann JW Jr, Whitley RJ (2017) Herpes simplex encephalitis: an update. Curr Infect Dis Rep 19:13

    Article  Google Scholar 

  • Gong T, Bingaman W, Danziger-Isakov L, Tuxhorn I, Goldfarb J (2010) Herpes simplex virus reactivation after subtotal hemispherectomy in a pediatric patient. Pediatr Infect Dis J 29:1148–1150

    Article  Google Scholar 

  • Ihekwaba UK, Battersby RD (2009) Type 2 herpes simplex reactivation after craniocervical decompression for hind brain hernia and associated syrinx. Br J Neurosurg 23:326–328

    Article  Google Scholar 

  • Jalloh I, Guilfoyle MR, Lloyd SKW, Macfarlane R, Smith C (2009) Reactivation and centripetal spread of herpes simplex virus complicating acoustic neuroma resection. Surg Neurol 72:502–504

    Article  Google Scholar 

  • Jaques DA, Bagetakou S, L'Huillier AG, Bartoli A, Vargas M, Fluss J, Kaiser L (2016) Herpes simplex encephalitis as a complication of neurosurgical procedures: report of 3 cases and review of the literature. Virol J 13:83

    Article  Google Scholar 

  • Joos AA, Ziyeh S, Rauer S, Keller E, Huzly D, Lücking CH (2003) Postinfectious autoimmune-mediated encephalitis eight months after herpes simplex encephalitis. Eur Neurol 50:54–56

    Article  CAS  Google Scholar 

  • Kennedy PGE, Chaudhuri A (2002) Herpes simplex encephalitis. J Neurol Neurosurg Psychiatry 73:237–238

    Article  CAS  Google Scholar 

  • Kennedy PGE, Steiner I (2013) Recent issues in herpes simplex encephalitis. J Neuro-Oncol 19:346–350

    Google Scholar 

  • Kim SH, Lee SG, Kim SH, Kim DS, Kim HD (2013) Relapsed herpes simplex virus encephalitis after epilepsy surgery. J Epilepsy Res 3:28–31

    Article  Google Scholar 

  • Kwon J-W, Cho B-K, Kim EC, Wang K-C, Kim S-K (2008) Herpes simplex encephalitis after craniopharyngioma surgery. J Neurosurg Pediatr 2:355–358

    Article  Google Scholar 

  • Lellouch-Tubiana A, Fohlen M, Robain O, Rozenberg F (2000) Immunocytochemical characterization of long-term persistent immune activation in human brain after herpes simplex encephalitis. Neuropathol Appl Neurobiol 26:285–294

    Article  CAS  Google Scholar 

  • Lo Presti A, Weil AG, Niazi TN, Bhatia S (2015) Herpes simplex reactivation or postinfectious inflammatory response after epilepsy surgery: case report and review of the literature. Surg Neurol Int 6:47

    Article  Google Scholar 

  • Lund M (2011) Herpes simplex virus reactivation and encephalitis after topectomy. J Pediatr Health Care 25:323–327

    Article  Google Scholar 

  • Mallory GW, Wilson JW, Castner ML, Driscoll CLW, Link MJ (2012) Herpes simplex meningitis after removal of a vestibular schwannoma: case report and review of the literature. Otol Neurotol 33:1422–1425

    Article  Google Scholar 

  • Molloy S, Allcutt D, Brennan P, Farrell MA, Perryman R, Brett FM (2000) Chemotherapy, surgery, and stereotactic radiotherapy for medulloblastoma. Arch Pathol Lab Med 124:1809–1812

    CAS  PubMed  Google Scholar 

  • Monteiro de Almeida S, Crippa A, Cruz C, de Paola L, de Souza LP, Noronha L, Torres LF, Koneski JA, Pessa LF, Nogueira MB, Raboni SM, Silvado CE, Vidal LR (2015) Reactivation of herpes simplex virus-1 following epilepsy surgery. Epilepsy Behav Case Rep 4:76–78

    Article  Google Scholar 

  • Ochsner F (1981) Contamination of a glioma by herpes simplex virus. Schweiz Arch Neurol Neurochir Psychiatr 129:19–30

    CAS  PubMed  Google Scholar 

  • Perry JD, Girkin CA, Miller NR, Kerr DA (1998) Herpes simplex encephalitis and bilateral acute retinal necrosis syndrome after craniotomy. Am J Ophthalmol 126:456–460

    Article  CAS  Google Scholar 

  • Ploner M, Turowski B, Gabriele W (2005) Herpes encephalitis after meningioma resection. Neurology 65:1674–1675

    Article  Google Scholar 

  • Prim N, Benito N, Montes G, Pomar V, Molet J, Rabella N (2013) Human herpesvirus 1 meningoencephalitis after trigeminal neuralgia surgery. J Inf Secur 67:79–81

    Google Scholar 

  • Raper DMS, Wong A, McCormick PC, Lewis LD (2011) Herpes simplex encephalitis following spinal ependymoma resection: case report and literature review. J Neuro-Oncol 103:771–776

    Article  Google Scholar 

  • Rigamonti A, Lauria G, Mantero V, Salmaggi A (2013) A case of late herpes simplex encephalitis relapse. J Clin Virol 58:269–270

    Article  Google Scholar 

  • Sheleg S, Nedzved M, Nedzved A, Kulichkovskaya I (2001) Contamination of glioblastoma multiforme with type 1 herpes simplex virus. J Neurosurg 95:721

    Article  CAS  Google Scholar 

  • Skoldenberg B, Aurelius E, Hjalmarsson A et al (2006) Incidence and pathogenesis of clinical relapse after herpes simplex encephalitis in adults. J Neurol 253:163–170

    Article  CAS  Google Scholar 

  • Spuler A, Blaszyk H, Parisi JE, Davis DH (1999) Herpes simplex encephalitis after brain surgery: case report and review of the literature. J Neurol Neurosurg Psychiatry 67:239–242

    Article  CAS  Google Scholar 

  • Tunkel AR, Glaser CA, Bloch KC, Sejvar JJ, Marra CM, Roos KL, Hartman BJ, Kaplan SL, Scheld WM, Whitley RJ, Infectious Diseases Society of America (2008) The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 47:303–327

    Article  CAS  Google Scholar 

  • Uda T, Koide R, Ito H, Hosono A, Sunaga S, Morino M (2013) Relapse of herpes simplex virus encephalitis after surgical treatment for temporal lobe epilepsy: rare complication of epilepsy surgery. J Neurol 260:318–320

    Article  Google Scholar 

  • Vik-Mo EO, Krossnes BK, Stanisic M, Egge A, Holter E, Taubøll E, Heuser K, Lund CG (2014) Reactivation of occult herpes simplex meningoencephalitis after temporal lobe resection for refractory epilepsy–a case report. Seizure 23:321–323

    Article  Google Scholar 

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Authors and Affiliations

  1. Neurological Department, “A. Manzoni” Hospital – ASST Lecco, Via dell’Eremo 9/11, 23900, Lecco, Italy

    Vittorio Mantero, Andrea Rigamonti, Anna Fiumani, Paola Basilico & Andrea Salmaggi

  2. “Claudio Munari” Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy

    Massimo Cossu & Laura Tassi

Authors
  1. Vittorio Mantero
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  2. Massimo Cossu
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  3. Andrea Rigamonti
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  4. Anna Fiumani
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  5. Paola Basilico
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  6. Laura Tassi
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  7. Andrea Salmaggi
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All authors approved the contents of the manuscript and validated the accuracy of the data.

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Correspondence to Vittorio Mantero.

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Mantero, V., Cossu, M., Rigamonti, A. et al. HSV-1 encephalitis relapse after epilepsy surgery: a case report and review of the literature. J. Neurovirol. 26, 138–141 (2020). https://doi.org/10.1007/s13365-019-00796-1

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  • DOI: https://doi.org/10.1007/s13365-019-00796-1

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