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Published in: Journal of NeuroVirology 5/2021

01-10-2021 | Herpes Simplex Encephalitis

Herpes simplex encephalitis in patients receiving chemotherapy and whole-brain radiation therapy

Authors: Nir Hersh, Israel Steiner, Tali Siegal, Felix Benninger

Published in: Journal of NeuroVirology | Issue 5/2021

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Abstract

Herpes simplex encephalitis (HSE) is a very severe infection of the central nervous system (CNS) caused mainly by herpes simplex virus type 1 (HSV-1) and occasionally by herpes simplex virus type 2 (HSV-2). After relapse or drug-resistant to chemotherapy, whole-brain radiation therapy (WBRT) is a mainstay of treatment in patients with both identifiable brain metastases and CNS lymphoma. Although HSV-1 encephalitis predominantly affects immunocompetent host, HSV encephalitis may be more common in immune-suppressed patients than is currently recognized. Disease presentation may be atypical including lack of pleocytosis in cerebrospinal fluid (CSF). We report four patients diagnosed with HSE following chemotherapy and WBRT. The occurrence of HSE in patients with cancer seems not to be increased compared to the general population, but as our case series shows, a high level of suspicion is needed by the treating physician to diagnose HSE early in patients presenting with new neurological symptoms following WBRT.
Literature
go back to reference Dragoje S, Tolnay M, Dalquen P, Probst A (1995) Brain irradiation and antioedematous dexamethasone treatment--risk factors for herpes simplex encephalitis?. Schweizer Archiv fur Neurologie und Psychiatrie (Zurich, Switzerland: 1985)146(6):277–280. Retrieved from. http://europepmc.org/abstract/MED/8867358 Dragoje S, Tolnay M, Dalquen P, Probst A (1995) Brain irradiation and antioedematous dexamethasone treatment--risk factors for herpes simplex encephalitis?. Schweizer Archiv fur Neurologie und Psychiatrie (Zurich, Switzerland: 1985)146(6):277–280. Retrieved from. http://​europepmc.​org/​abstract/​MED/​8867358
go back to reference Spacca B, Mallucci C, Riordan A, Appleton R, Thorp N, Pizer B (2007) HSV encephalitis in a child with brain stem glioma: a rare complication of therapy. Case report and review of the neurosurgical literature. Childs Nerv Syst 23(11):1347–1350. https://doi.org/10.1007/s00381-007-0389-3 Spacca B, Mallucci C, Riordan A, Appleton R, Thorp N, Pizer B (2007) HSV encephalitis in a child with brain stem glioma: a rare complication of therapy. Case report and review of the neurosurgical literature. Childs Nerv Syst 23(11):1347–1350. https://​doi.​org/​10.​1007/​s00381-007-0389-3
Metadata
Title
Herpes simplex encephalitis in patients receiving chemotherapy and whole-brain radiation therapy
Authors
Nir Hersh
Israel Steiner
Tali Siegal
Felix Benninger
Publication date
01-10-2021
Publisher
Springer International Publishing
Published in
Journal of NeuroVirology / Issue 5/2021
Print ISSN: 1355-0284
Electronic ISSN: 1538-2443
DOI
https://doi.org/10.1007/s13365-021-01018-3

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