Limits of Early Diagnosis of Herpes Simplex Encephalitis in Children: A Retrospective Study of 38 Cases

The prognosis of herpes simplex encephalitis (HSE) depends on the early and appropriate administration of specific an-tiviral therapy. We retrospectively reviewed 38 cases of chil-dren with proven HSE, to evaluate the reliability of poly-merase chain reaction results, according to the time of cerebrospinal fluid (CSF) sampling. Initial negative results were observed in 8 of 33 CSF samples drawn before day 3 of the disease and were significantly associated with a low level of protein and!10 leukocytes/mm3 in the CSF. Herpes simplex virus (HSV) is the most common cause of acute sporadic focal encephalitis in Western countries. The incidence of HSV encephalitis (HSE) is estimated to be 1–4 cases/106 people/year, and nearly 30 % of these occur in patients aged!20 years [1, 2]. The prognosis of the disease has been signif-icantly improved by acyclovir treatment, provided that the drug is administered very early after the onset of symptoms [1, 3]