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A 47-year-old man had recurrent signs and symptoms of brain stem encephalitis of a 4-year period.Although CSF viral cultures were repeatedly negative,herpes simplex virus type 1(HSV-1)DNA was detected in CSF by polymerase chain reaction(PCR).HSV-1-specific antibodies were absent at the time of the first positive PCR test,but CSF seroconversion to high HSV-1-specific antibody titer subsequently occurred.CSF antibody to cytomegalovirus(CMV)and varicella-zoster virus(VZV)was not detectable, nor could CMV,VZV,or Epstein-Barr virus nucleic acid be detected in CSF by PCR.This is the first report of the use of CSF PCR for the rapid antemortem diagnosis of herpetic brainstem encephalitis. |
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brainstem
brainstem,lesion of
cerebrospinal fluid
cerebrospinal fluid,abnormal
encephalitis
encephalitis,brainstem
encephalitis,viral
herpes simplex encephalitis
herpes simplex encephalitis,atypical
herpes simplex encephalitis,diagnosis of
herpes simplex encephalitis,recurrent
neurologic disease,diagnoses of
polymerase chain reaction
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