Herpes simplex virus encephalitis: Clinical manifestations, diagnosis and outcome in 106 adult patients

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dc.authorid0000-0001-8945-2385
dc.contributor.authorSili, Uluhan
dc.contributor.authorKaya, Abdurrahman
dc.contributor.authorMert, Ali
dc.contributor.authorÖzaras, Reşat
dc.contributor.authorMidilli, Kenan
dc.contributor.authorAlbayram, Sait
dc.contributor.authorKenangil, Gülay
dc.contributor.authorDemirci, Onat
dc.contributor.authorKapmaz, Mahir
dc.contributor.authorKart Yaşar, Kadriye
dc.contributor.authorÖzyavuz Alp, Şehnaz
dc.contributor.authorÜnal Kayaaslan, Bircan
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:57:45Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:57:45Z
dc.date.issued2014
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.descriptionWOS: 000335738000006
dc.descriptionPubMed ID: 24768322
dc.description.abstractBackground: Herpes simplex virus (HSV) is one of the most common causes of sporadic encephalitis worldwide. Objective: We aimed to determine clinical characteristics and prognosis of HSV encephalitis (HSVE) cases reviewed retrospectively from several collaborating centers. Study design: We searched hospital archives of the last 10 years for patients with HSVE diagnosis, i.e. clinical presentation compatible with encephalitis and brain involvement on magnetic resonance imaging (MRI) and/or detection of HSV DNA in the cerebrospinal fluid by polymerase chain reaction (PCR). Clinical characteristics were noted and patients were phone-interviewed. HSVE cases were grouped and analyzed as proven and probable, based on virological confirmation by PCR. Univariate and multivariate analyses were used to determine factors associated with prognosis. Results: A total of 106 patients (63 males and 43 females; mean age, 44 years; range, 18-83 years) were included. Most common symptoms were changes in mental status, fever, headache, and seizure. HSV PCR was positive in 69% of patients tested, while brain involvement was detected on MRI in 95%. Acyclovir was started mostly within five days of main symptom and continued for >= 14 days. Case fatality rate was 8%, while 69% of patients recovered with sequelae. Favorable prognosis was observed in 73% of patients. Multivariate analysis identified the duration of disease before hospital admission (odds ratio (OR) = 1.24) and the extent of brain involvement on MRI at the time of admission (OR = 37.22) as two independent risk factors associated with poor prognosis. Conclusions: Although HSVE fatality regressed considerably with acyclovir treatment, many patients survive with sequelae. Our results emphasize the importance of early diagnosis and prompt treatment of HSVE.
dc.identifier.citationSili, U., Kaya, A., Mert, A., Özaras, R., Midilli, K. ,Albayram, S. ... Ünal Kayaaslan, B. (2014). Herpes simplex virus encephalitis: Clinical manifestations, diagnosis and outcome in 106 adult patients. Journal of Clinical Virology, 60(2), 112-118. https://dx.doi.org/10.1016/j.jcv.2014.03.010
dc.identifier.doi10.1016/j.jcv.2014.03.010
dc.identifier.endpage118
dc.identifier.issn1386-6532
dc.identifier.issn1873-5967
dc.identifier.issue2
dc.identifier.scopusqualityQ1
dc.identifier.startpage112
dc.identifier.urihttps://dx.doi.org/10.1016/j.jcv.2014.03.010
dc.identifier.urihttps://hdl.handle.net/20.500.12511/3043
dc.identifier.volume60
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofJournal of Clinical Virologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectHerpes Simplex Virus
dc.subjectViral Encephalitis
dc.subjectPrognostic Factorsa
dc.titleHerpes simplex virus encephalitis: Clinical manifestations, diagnosis and outcome in 106 adult patients
dc.typeArticle

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