Early-onset herpes simplex encephalitis type 1 triggered by COVID-19 disease: A case report

• Published in: Radiology case reports Vol. 19; no. 3; pp. 855 - 858
• Main Authors: Inoue, Kai, Aoki, Hanako, Toru, Shuta, Hatano, Yu, Imase, Reina, Takasaki, Hiroshi, Tanaka, Michiko, Adachi, Saori, Yokote, Hiroaki, Akiyama, Hideki, Yamane, Michio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier 01-03-2024
• Subjects: Acyclovir; COVID-19; HSV-1 encephalitis; Reactivation; Vidarabine; COVID-19; Vidarabine; Reactivation; HSV-1 encephalitis; Acyclovir
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2023.11.044

Coronavirus disease 2019 (COVID-19) causes a systemic inflammatory response and a temporary immunosuppression of hosts. Several reports have showed that reactivation of herpes simplex virus type 1 (HSV-1) is strongly associated with COVID-19. We present a case of a 66-year-old female, who developed HSV-1 encephalitis, showing impaired consciousness and typical MRI findings such as hyperintense lesions in the temporal lobe, insular cortices, bilateral medial frontal lobe on diffusion-weighted imaging, 7 days after the onset of COVID-19 symptoms. The number of cases of encephalitis in patients with COVID-19 is increasing. However, there has been limited reports of HSV-1 encephalitis following COVID-19, especially for cases with an interval of 7 days or less from the onset of COVID-19 symptoms to the onset of HSV-1 encephalitis. Our case highlights the importance of considering HSV-1 encephalitis in the differential when managing a patient with COVID-19-associated neurologic complications, even if it is in the early stages of COVID-19.