Background: Herpes simplex virus (HSV) is the most common identified cause of focal encephalitis worldwide. However, postoperative HSV encephalitis (HSVE) is a rare complication of neurosurgical procedures and a significant clinical challenge Method: We describe 3 cases of postoperative HSVE and review all published reports. A total of 23 cases were identified. Discussion: Clinical heterogeneity represents a diagnostic challenge in the postoperative setting. Cerebral magnetic resonance imaging showed typical findings in a minority of patients only, whereas HSV-specific polymerase chain reaction on the cerebrospinal fluid proved to be a valuable test. The postoperative viral pathophysiology remains a subject of debate. The rate of adverse outcome is high and early antiviral treatment seems to be a strong predictor of clinical outcome. Conclusion: We recommend early empirical treatment for any patient presenting with post-neurosurgical lymphocytic meningo-encephalitis, and prophylactic antiviral treatment for patients with a history of previous HSVE who will undergo a neurosurgical procedure.
CITATION STYLE
Jaques, D. A., Bagetakou, S., L’Huillier, A. G., Bartoli, A., Vargas, M. I., Fluss, J., & Kaiser, L. (2016, May 23). Herpes simplex encephalitis as a complication of neurosurgical procedures: Report of 3 cases and review of the literature. Virology Journal. BioMed Central Ltd. https://doi.org/10.1186/s12985-016-0540-4
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