SHORT REPORT Atypical herpes type 2 encephalitis associated with normal MRI imaging

We describe a case of chronic atypical herpes simplex type 2 encephalitis in an immunocompromised 68 year old man presenting with headache and cognitive changes without focal neurological or MRI findings. To our knowledge this is the first described case of herpes simplex encephalitis associated with normal MRI brain imaging and non-focal neurological examination. This further expands the range of clinical presentations that may be associated with herpes simplex encephalitis and empha-sises the value of PCR for herpes simplex virus in the inves-tigation of encephalitis regardless of imaging findings. Herpes simplex encephalitis is one of the most severeviral infections of the brain. Estimates of annualincidence vary but are in the order of 1.2 cases per mil-lion population per annum.1 The classical clinical presentation includes a syndrome of acute onset characterised by fever, headache, altered mentation, focal neurological signs, an