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Relapse of Herpes Simplex Encephalitis in Children
Pediatrics 89:891-894, Kimura,H.,et al, 1992
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Article Abstract
The polymerase chain reaction method was used to diagnose herpes simplex encephalitis in children.Initial samples of cerebrospinal fluid from 15 patients with herpes simplex encephalitis were all positive for the herpes simplex virus DNA by polymerase chain reaction assay.In terms of early diagnosis,polymerase chain reaction assay became positive significantly earlier than the detection of intrathecally produced anti-herpes simplex virus antibody using the enzyme-linked immunosorbent assay(4.4 vs 8.9 days after onset;P<.01).Serial examinations showed that the presence of virus DNA in cerebrospinal fluid continued for 3 to 18 days after the neurologic onset(mean 10.1 days).Four of the 15 patients had a relapse of encephalitis after completing acyclovir therapy.The mean duration of initial acyclovir therapy in the recurrent group was significantly shorter than that in the nonrecurrent group.In recurring cases,herpes simplex virus DNA reappeared temporarily in the cerebrospinal fluid of two patients.These results show that polymerase chain reaction assay is a useful diagnostic tool for the early and noninvasive diagnosis of herpes simplex encephalitis in children.Results also suggest that a comparatively short duration of acyclovir therapy may be related to a relapse of herpes simplex encephalitis in some children.
 
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acyclovir
antiviral agents
cerebrospinal fluid
encephalitis
herpes simplex encephalitis
herpes simplex encephalitis,infancy and childhood
herpes simplex encephalitis,recurrent
herpes simplex encephalitis,treatment of
neurologic disease,diagnoses of
polymerase chain reaction
treatment of neurologic disorder

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