Infect Chemother.  2011 Apr;43(2):222-224. 10.3947/ic.2011.43.2.222.

Encephalitis by Co-infection with A/H1N1 Influenza and Herpes Simplex Virus in an Adult Patient

• Joo EJ
• Kang CI
• Kim YJ
• Chung DR
• Peck KR
• Song JH

• KMID: 1782367
• DOI: http://doi.org/10.3947/ic.2011.43.2.222

Abstract

Influenza-associated encephalopathy is rare in adults and the role of influenza virus in the pathogenesis of influenza-associated encephalopathy is unclear. We report a case of an adult patient who presented with typical clinical manifestations and magnetic resonance imaging findings of herpes simplex virus (HSV) encephalitis confirmed by positive PCR test in cerebrospinal fluid (CSF), and who was also PCR-positive PCR for H1N1 A/influenza in CSF and a nasopharyngeal swab. The results strongly suggest co-infection of the central nervous system. Given the significant implications for therapeutic interventions and infection control, A/H1N1 influenza should be considered one of the possible etiologies of viral encephalitis when patients present with an influenza-like illness during an influenza epidemic, even in those with typical manifestation of HSV encephalitis.

Keyword

Influenza A virus; Herpes simplex virus; Encephalitis; H1N1

MeSH Terms

Adult
Central Nervous System
Coinfection
Encephalitis
Encephalitis, Viral
Herpes Simplex
Humans
Infection Control
Influenza A virus
Influenza, Human
Magnetic Resonance Imaging
Methylmethacrylates
Orthomyxoviridae
Polymerase Chain Reaction
Polystyrenes
Simplexvirus
Methylmethacrylates
Polystyrenes

Figure

• 

  Figure 1 Brain MRI shows T2 high-signal intensity lesions in the left insula (thick arrow) and temporal (thin arrow) lobes associated with sulcal hyperintensity.

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