Outcome of and Prognostic Factors for Herpes Simplex Encephalitis in Adult Patients: Results of a Multicenter Study
Top Cited Papers
Open Access
- 1 August 2002
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 35 (3), 254-260
- https://doi.org/10.1086/341405
Abstract
Management of herpes simplex encephalitis (HSE) has been considerably improved by the availability of acyclovir therapy and rapid polymerase chain reaction (PCR)—based diagnostic assays. Prognostic factors for this rare affliction are, however, misestimated. We conducted a large retrospective multicenter study that included 93 adult patients in whom HSE was diagnosed by PCR from 1991 through 1998 and who were treated with intravenous acyclovir. Among the 85 patients assessed at 6 months, 30 (35%) had a poor outcome, which led to death in 13 patients (15%) and severe disability in 17 (20%). The outcome was favorable for 55 patients (65%). A multivariate analysis identified 2 factors that were found to be independently associated with poor outcome: a Simplified Acute Physiology Score II ⩾27 at admission and a delay of >2 days between admission to the hospital and initiation of acyclovir therapy. Early administration of antiviral therapy is the only parameter that can be modified to improve the prognosis of patients with HSE.This publication has 24 references indexed in Scilit:
- The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis.Journal of Neurology, Neurosurgery & Psychiatry, 1996
- Diagnosis of Herpes Simplex Encephalitis: Application of Polymerase Chain Reaction to Cerebrospinal Fluid from Brain-Biopsied Patients and Correlation with DiseaseThe Journal of Infectious Diseases, 1995
- Herpes simplex encephalitis: long term magnetic resonance imaging and neuropsychological profile.Journal of Neurology, Neurosurgery & Psychiatry, 1994
- Rapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluidThe Lancet, 1991
- Viral EncephalitisThe New England Journal of Medicine, 1990
- Long-term Cognitive Sequelae of Acyclovir-Treated Herpes Simplex EncephalitisArchives of Neurology, 1990
- Non-invasive diagnosis of herpes simplex encephalitisThe Lancet, 1990
- Vidarabine versus Acyclovir Therapy in Herpes Simplex EncephalitisThe New England Journal of Medicine, 1986
- ACYCLOVIR VERSUS VIDARABINE IN HERPES SIMPLEX ENCEPHALITIS: Randomised Multicentre Study in Consecutive Swedish PatientsThe Lancet, 1984
- Adenine Arabinoside Therapy of Biopsy-Proved Herpes Simplex EncephalitisThe New England Journal of Medicine, 1977