Diagnosis and surveillance of herpes simplex virus infection of the central nervous system

Herpes simplex viruses (HSV) are responsible for neurological disorders tha t require rapid diagnostic methods and specific antiviral therapy. During 1 997, 1431 cerebrospinal fluid samples (CSF) collected from 1339 patients wi th neurological disorder presentations were processed for HSV detection. El even patients were positive for HSV, seven presenting with encephalitis (6/ 7 due to HSV1) and 4 with aseptic meningitis (4/4 due to HSV2). The inciden ce of HSV encephalitis was 2.33 cases / 10(6) inhabitants/ year. Among ence phalitis (HSV encephalitis) cases, 1 patient died due to the late implement ation of antiviral therapy, and sequelae were observed in 4 cases. No seque lae were observed in aseptic meningitis cases. Four HSV encephalitis cases were monitored by PCR detection in CSF. Despite acyclovir therapy, PCR rema ined positive in CSF up to 20 days in 2 cases. This result suggest that the antiviral treatment for HSV encephalitis should be monitored by PCR detect ion of HSV in CSF. J. Med. Virol. 61:468-4 73, 2000. (C) 2000 Wiley-Liss, I nc.