Encephalitis is a syndrome characterized by altered mental status along with acute fever, seizures, and neurological deficits. The syndrome has many causes, the most commonly identified causes are neurotropic viruses. Herpes simplex virus (HSV) encephalitis is a potentially life-threatening condition which can be diagnosed with a combination of history, examination, magnetic resonance imaging (MRI) brain, and lumbar puncture. We report a case of a young immunocompetent adult presented with fever, altered mentation, and seizure. We are reporting classical findings of HSV encephalitis in an MRI brain study. We also described a few common viral encephalitis encountered in clinical practice.
Tyler KL. Acute viral encephalitis. N Engl J Med 2018;379(6):557–566. DOI: 10.1056/nejmra1708714
Granerod J, Ambrose HE, Davies NW, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010;10(12):835–844. DOI: 10.1016/S1473-3099(10)70222-X
Wu Y, Xu X, Chen Z, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun 2020;87:18–22. DOI: 10.13039/501100001809
Jayaraman K, Rangasami R, Chandrasekharan A. Magnetic resonance imaging findings in viral encephalitis: a pictorial essay. J Neurosci Rural Pract 2018;9(4):556–560. DOI: 10.4103/jnrp.jnrp_120_18
Verma R. MRI features of Japanese encephalitis. BMJ Case Rep 2012;2012:bcr0320126088. DOI: 10.1136/bcr.03.2012.6088
Yun SI, Lee YM. Japanese encephalitis: the virus and vaccines. Hum Vaccin Immunother 2014;10(2):263–279. DOI: 10.4161/hv.26902
Soni BK, Das DS, George RA, et al. MRI features in dengue encephalitis: a case series in South Indian tertiary care hospital. Indian J Radiol Imaging 2017;27(2):125–128. DOI: 10.4103/ijri.ijri_322_16
Vyas S, Ray N, Maralakunte M, et al. Pattern recognition approach to brain MRI findings in patients with dengue fever with neurological complications. Neurol India 2020;68(5):1038–1047. DOI: 10.4103/0028-3886.294556
Kremer S, Lersy F, de Sèze J, et al. Brain MRI findings in severe COVID-19: a retrospective observational study. Radiology 2020;297(2):E242–E251. DOI: 10.1148/radiol.2020202222
Hayashi M, Sahashi Y, Baba Y, et al. COVID-19-associated mild encephalitis/encephalopathy with a reversible splenial lesion. J Neurol Sci 2020;415:116941. DOI: 10.1016/j.jns.2020.116941
Langford TD, Letendre SL, Larrea GJ, et al. Changing patterns in the neuropathogenesis of HIV during the HAART era. Brain Pathol 2003;13(2):195–210. DOI: 10.1111/j.1750-3639.2003.tb00019.x
Valcour V, Paul R, Chiao S, et al. Screening for cognitive impairment in human immunodeficiency virus. Clin Infect Dis 2011;53(8):836–842. DOI: 10.1093/cid/cir524
Sonneville R, Klein I, de Broucker T, et al. Post-infectious encephalitis in adults: diagnosis and management. J Infect 2009;58(5):321–328. DOI: 10.1016/j.jinf.2009.02.011
Ravi V, Hameed SKS, Desai A, et al. An algorithmic approach to identifying the aetiology of acute encephalitis syndrome in India: results of a 4-year enhanced surveillance study. Lancet Glob Health 2022;10(5):e685–e693. DOI: 10.1016/S2214-109X(22)00079-1
Granerod J, Davies NW, Mukonoweshuro W, et al. Neuroimaging in encephalitis: analysis of imaging findings and interobserver agreement. Clin Radiol 2016;71(10):1050–1058. DOI: 10.13039/501100000317
Beckham JD, Tyler KL. Initial management of acute bacterial meningitis in adults: summary of IDSA guidelines. Rev Neurol Dis 2006;3(2):57–60. PMID: 16819421.
Glimåker M, Sjölin J, Åkesson S, et al. Lumbar puncture performed promptly or after neuroimaging in acute bacterial meningitis in adults: a prospective national cohort study evaluating different guidelines. Clin Infect Dis 2018;66(3):321–328. DOI: 10.1093/cid/cix806
Feng G, Zhou L, Li F, et al. Predictors of outcome in clinically diagnosed viral encephalitis patients: a 5-year prospective study. Biomed Res Int 2020;2020:2832418. DOI: 10.1155/2020/2832418
Sarton B, Jaquet P, Belkacemi D, et al. Assessment of magnetic resonance imaging changes and functional outcomes among adults with severe herpes simplex encephalitis. JAMA Netw Open 2021;4(7):e2114328. DOI: 10.1001/jamanetworkopen.2021.14328
Jardim Vaz de Mello L, Seifi A, Perez I, et al. Electroencephalography during the acute phase of encephalitis: a brief review. J Neurol Res 2020;10(2):32–37. DOI: https://doi.org/10.14740/jnr568
