Abstract
Background: Herpes simplex virus (HSV) encephalitis is a serious illness of the nervous system in children. While acyclovir treatment improves outcomes, mortality and morbidity are still considerable. Hemorrhagic consequences are uncommon and can cause diagnostic delays. This case report describes a child who experienced intraparenchymal bleeding as a result of temporal lobe encephalitis caused by the herpes simplex virus.
Case Presentation: An 8-month-old girl presented with fever, convulsions, and lethargy. Her initial antibiotic treatment did not improve her condition. CSF PCR proved HSV-1 encephalitis and brain CT showed intraparenchymal hemorrhage, which was a delayed finding. MRI revealed temporal lobe, basal ganglia, and posterior fossa involvement, which was consistent with HSV encephalitis. Treatment with acyclovir began promptly and the patient responded very well.
Conclusion: This case study highlights how patients with HSV encephalitis who do not improve with treatment should be evaluated for intraparenchymal bleeding. Prompt action and early diagnosis are essential for successful management.