Is Herpes Simplex Encephalitis Different in Infants and Toddlers?

Excerpt

To the Editor: Herpes simplex virus encephalitis (HSE) is a treatable cause of acute sporadic encephalitis with a mortality rate of 50-70% with no or incomplete treatment [1, 2]. Diagnosis is based on the classical involvement of the medial and inferior aspects of the temporal lobe. However, this is not usually seen in children below 3 y, where hematogenous spread, either by diffusing through the blood-brain-barrier or by infecting the endothelial cells of blood vessels in the brain, leads to cortical or white-matter lesions that involves all lobes, insulae, or thalami corresponding to the vascular distribution pattern [1‐3]. Unfortunately, the awareness of this fact is lacking amongst radiologists and pediatricians thereby leading to missed/delayed diagnosis. …