HERPES-SIMPLEX VIRUS TYPE-2 ENCEPHALITIS AND CONCOMITANT CYTOMEGALOVIRUS-INFECTION IN A PATIENT WITH AIDS - DETECTION OF VIRUS-SPECIFIC DNAIN CSF BY NESTED POLYMERASE CHAIN-REACTION

A Caucasian homosexual man with AIDS and cytomegalovirus retinitis pre sented with facial pain and episodic confusion, had several seizures a nd became obtunded. An. electroencephalogram was suggestive of herpes simplex encephalitis. The diagnosis was confirmed by detection of herp es simplex virus type 2 (HSV-2), but not type 1, DNA in cell-free cere brospinal fluid (CSF) after amplification by nested polymerase chain r eaction. The patient also had evidence of concomitant cytomegalovirus (CMV) infection with detectable CMV DNA in CSF. With high-dose acyclov ir the patient recovered. Analysis of a follow up CSF sample taken fou r months later showed no detectable HSV-2 DNA.