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COMMENTARY
Year : 2021  |  Volume : 14  |  Issue : 4  |  Page : 465  

Herpes simplex, encephalitis, and predisposing factor


Depatment of Community, Dr. DY Patil University, Pune, Maharashtra, India; Department of Tropical Medicine, Hainan Medical University, Haikou, China, India

Date of Submission20-Feb-2020
Date of Decision08-May-2020
Date of Acceptance10-May-2020
Date of Web Publication17-Jun-2021

Correspondence Address:
Viroj Wiwanitkit
Depatment of Community, Dr. DY Patil University, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_55_20

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How to cite this article:
Wiwanitkit V. Herpes simplex, encephalitis, and predisposing factor. Med J DY Patil Vidyapeeth 2021;14:465

How to cite this URL:
Wiwanitkit V. Herpes simplex, encephalitis, and predisposing factor. Med J DY Patil Vidyapeeth [serial online] 2021 [cited 2021 Nov 28];14:465. Available from: https://www.mjdrdypv.org/text.asp?2021/14/4/465/318696



Herpes simplex infection is an important virus infection. The central nervous system involvement of herpes simplex is interesting. In the publication in the Journal,[1] a good example of herpes simplex encephalitis is presented. This condition is life-threatening.[2] Since it is a common kind of viral encephalitis, a practitioner has to recognize and to properly manage a patient.[2] For diagnosis, immunological diagnosis has limited utility and the gold standard for diagnosis is molecular diagnosis using polymerase chain reaction of the cerebrospinal fluid.[3] Nevertheless, the presumptive diagnosis is usually by neuroimaging study (computed tomography or magnetic resonance imaging) or electroencephalography.[4] Antiviral therapy, high-dose acyclovir, is proven useful in the management of the patient[4] and helps reduce mortality and complications.[5] In addition to encephalitis, the patient might also have meningitis.[3] In very rare case, retinal necrosis might be a late complication following herpes simplex encephalitis.[6]

In the present report in the Journal,[1] an interesting issue is on the predisposing factors of herpes simplex encephalitis. Either chemotherapy or chronic alcoholism, as known immunodeteriorating environmental factors, might predispose herpes simplex encephalitis. Nevertheless, new data show the role of genetic predisposing factors. As noted by Zhang et al., genetic defects in the Toll-like receptor (TLR3)-interferon (IFN) and IFN-responsive pathways could predispose the encephalitis.[7] The interrelationship among possible environmental and genetic predisposing for herpes simplex encephalitis is interesting and warrants further researches.



 
  References Top

1.
Benachinmardi K, Chikkannaiah P. A case of herpes simplex encephalitis: Predisposing factors-chemotherapy or chronic alcoholism?. Med J DY Patil Vidyapeeth 2021;14:66-8.  Back to cited text no. 1
  [Full text]  
2.
Bradshaw MJ, Venkatesan A. Herpes simplex virus-1 encephalitis in adults: Pathophysiology, diagnosis, and management. Neurotherapeutics 2016;13:493-508.  Back to cited text no. 2
    
3.
Tyler KL. Herpes simplex virus infections of the central nervous system: Encephalitis and meningitis, including Mollaret's. Herpes 2004;11 Suppl 2:57A-64A.  Back to cited text no. 3
    
4.
Shoji H. Japanese guidelines for the management of herpes simplex encephalitis; comparison with those from the International Management Herpes Forum. Rinsho Shinkeigaku 2006;46:955-7.  Back to cited text no. 4
    
5.
Buge A, Chamouard JM, Rancurel G. Prognosis of herpes simplex encephalitis. Retrospective study of 19 cases. Presse Med 1988;17:13-6.  Back to cited text no. 5
    
6.
Arruti M, Aldazabal M, Blanco A, Piñeiro L, Zapico MS, González F, et al. Acute herpes simplex virus type 1 retinal necrosis three years after herpes simplex encephalitis. Rev Neurol 2014;58:45-6.  Back to cited text no. 6
    
7.
Zhang SY, Abel L, Casanova JL. Mendelian predisposition to herpes simplex encephalitis. Handb Clin Neurol 2013;112:1091-7.  Back to cited text no. 7
    




 

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