caa a22 4500 463181212 CHVBK 20180406164839.0 cr unu---uuuuu 170326e20071101xx s 000 0 eng 10.1007/s00381-007-0389-3 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0389-3 HSV encephalitis in a child with brain stem glioma: a rare complication of therapy [Elektronische Daten] Case report and review of the neurosurgical literature [Barbara Spacca, Conor Mallucci, Andrew Riordan, Richard Appleton, Nicky Thorp, Barry Pizer] Background: Herpes simplex virus (HSV) encephalitis is a rare association with pediatric neurosurgical pathologies. Case report: A 13-year-old boy was diagnosed with an inoperable, biopsy-proven pontine grade II astrocytoma. During radiotherapy, he developed status epilepticus controlled by thiopentone with intubation and ventilation. Empiric cefotaxime and aciclovir were given. Lumbar cerebrospinal fluid (CSF) showed a normal white cell count, normal glucose, and a slightly elevated protein level. However, the CSF showed a positive polymerase chain reaction (PCR) for HSV type 1 DNA. Intravenous aciclovir was given for 21days and foscarnet for 7days. He was extubated after 4weeks at which time he was aphasic with spastic diplegia. After 8weeks, MRI brain scan showed the typical bitemporal pattern of HSV encephalitis. He made slow improvement but died 8months after diagnosis from tumor progression. Conclusion: HSV encephalitis is a rare but life threatening complication in neurosurgical patients. A low threshold for both investigation with CSF PCR and empirical treatment with intravenous aciclovir is warranted. As in this case, initial microscopic examination of the CSF may be normal. The literature on HSV encephalitis in neurosurgical patients is discussed. Springer-Verlag, 2007 Herpes simplex virus nationallicence Encephalitis nationallicence Brain stem nationallicence Glioma nationallicence Radiotherapy nationallicence Spacca Barbara Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut Mallucci Conor Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut Riordan Andrew Department of Infectious Diseases, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut Appleton Richard The Roald Dahl EEG Department, Paediatric Neurosciences Foundation, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut Thorp Nicky Clatterbridge Centre for Oncology, Bebington, Wirral, UK aut Pizer Barry Department of Oncology, Royal Liverpool Children's Hospital NHS Trust, Eaton Road, L12 2AP, Liverpool, UK aut Child's Nervous System Springer-Verlag 23/11(2007-11-01), 1347-1350 0256-7040 23:11<1347 2007 23 381 https://doi.org/10.1007/s00381-007-0389-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0389-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Spacca Barbara Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut NATIONALLICENCE 700 1- Mallucci Conor Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut NATIONALLICENCE 700 1- Riordan Andrew Department of Infectious Diseases, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut NATIONALLICENCE 700 1- Appleton Richard The Roald Dahl EEG Department, Paediatric Neurosciences Foundation, Royal Liverpool Children's Hospital NHS Trust, Liverpool, UK aut NATIONALLICENCE 700 1- Thorp Nicky Clatterbridge Centre for Oncology, Bebington, Wirral, UK aut NATIONALLICENCE 700 1- Pizer Barry Department of Oncology, Royal Liverpool Children's Hospital NHS Trust, Eaton Road, L12 2AP, Liverpool, UK aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/11(2007-11-01), 1347-1350 0256-7040 23:11<1347 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer