Epidemiology and Infection

Table of Contents - February 2012 - Volume 140, Issue 02  

Viruses

Herpes simplex encephalitis and management of acyclovir in encephalitis patients in France

J. P. STAHLa1, A. MAILLESa2 c1, T. De BROUCKERa3 and the Steering Committee and Investigators Group†

a1 Infectious Diseases Unit, University Grenoble 1, Grenoble, France

a2 French Institute for Public Health Surveillance, Saint-Maurice, France

a3 Neurology, Hospital of Saint-Denis, Saint-Denis, France

SUMMARY

This study reports on the clinical profiles of herpes simplex encephalitis (HSE) case-patients and the management of acyclovir prescriptions. We designed a study on the causes of encephalitis in France in 2007. Case-patients fulfilling the inclusion criteria were enrolled in all the hospitals that volunteered to participate. Fifty-five of 253 enrolled case-patients were diagnosed with HSE. Three (5%) HSE patients died and 48 (89%) were discharged with persistent neurological symptoms. All HSE patients were prescribed acyclovir, 10 of whom had a 2-week course; 42 a 3-week course; two received incomplete courses; and one received two courses of 21 days each due to relapse. The acyclovir dosage was reported for 45 adult HSE patients, 25 (53%) of whom received 10 mg/kg t.i.d. and 22 (47%) received 15 mg/kg t.i.d. The mortality rate was low despite 49% of patients being admitted to intensive-care units. A high dose of acyclovir was not associated with a better outcome in HSE patients. Most patients had persisting symptoms on discharge suggesting neuropsychological rehabilitation is an important issue for survivors.

(Accepted March 02 2011)

(Online publication April 07 2011)

Key Words:

Correspondence:

c1 Author for correspondence: Dr A. Mailles, Institut de veille sanitaire, 12 rue du val d'Osne 94415 Saint Maurice cedex. (Email: a.mailles@invs-sante.fr)

† The Steering Committee and Investigators Group are listed in the Appendix.

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