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Erschienen in:
01.03.2014 | Clinical Practice: Clinical Images
Confusion Secondary to Herpes Simplex Infection
Erschienen in: Journal of General Internal Medicine | Ausgabe 3/2014
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A 57-year-old woman presented with a rapid onset of headache, vomiting, and confusion. She had a temperature of 103° Fahrenheit and was delirious. Brain magnetic resonance imaging (MRI) showed high signal intensity in the right temporal, bilateral orbito-frontal lobes, and left temporal pole on T2-weighted imaging (Figs. 1 and 2). Cerebral spinal fluid (CSF) demonstrated lymphocytic pleocytosis with a red blood cell count of 45 cells/mm3. Intravenous acyclovir was started, and CSF polymerase chain reaction (PCR) subsequently returned positive for herpes simplex virus (HSV).
Figure 1.
MRI (T2-weighted image) demonstrating involvement of the medial temporal lobes, bilateral orbito-frontal lobes, cingulate gyrus, and insular cortex, as well as gyral edema.
Figure 2.
MRI (T2-weighted image) demonstrating involvement of the medial temporal lobes, bilateral orbito-frontal lobes, cingulate gyrus, and insular cortex, as well as gyral edema.
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