HERPES-SIMPLEX VIRUS BRAIN-STEM ENCEPHALITIS IN AN AIDS PATIENT

We report a case of a virulent, atypical herpes simplex infection in t he brainstem of a patient with Acquired Immune Deficiency Syndrome (AI DS) which was characterized by demyelination and oligodendroglial trop ism. At autopsy the brainstem showed demyelination. Immunocytochemistr y, in situ hybridization, and electron microscopy confirmed the presen ce of herpes simplex virus (HSV). Viral cultures demonstrated HSV type 1. Neuroinvasiveness and neurovirulence were studied by intraperitone al inoculation of susceptible mouse strains (A/J and Balb/cByJ) with d ifferent viral titers. The LD(50) of the clinical isolate was 5 orders of magnitude greater than the LD(50) of a laboratory HSV strain (HSV type 1 KOS). The brains of the mice inoculated with the clinical isola te showed brainstem and cerebellar demyelination.