ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG CỦA VIÊM NÃO DO HERPES SIMPLEX Ở CÁC BỆNH NHÂN ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG (2020 - 2021)

Abstract

Herpes simplex encephalitis (HSE) is a severe infection of the central nervous system with high morbidity and mortality rate due to late access to treatment.

Objectives: Describe the clinical and subclinical characteristics and outcomes of patients with HSE treated at the National Hospital for Tropical Diseases (NHTD) from January 2020 to June 2021.

Subjects and methods: A cross - sectional, descriptive study of patients diagnosed with HSE based on cerebrospinal fluid (CSF) abnormalities and positive PCR for Herpes simplex virus (HSV) in the CSF.

Results: In 34 HSE patients, the mean age was 54.4 years old and 73.5% of them were male. Common clinical manifestations were fever (100%), headaches (97.1%), unconsciousness (91.2%), and signs for meningitis (73.5%). Other manifestations were less common, including urinary disorders (44.1%), convulsions (35.3%) and hemiplegia (8.8%). Among 34 patients, 67.6% had leukocytosis, 85.3% had neutrophilia while 82.4% had hyponatremia. The brain lesions were commonly found in the temporal lobes (90.9%), insular lobes (57.5%), frontal lobes (42.4%), and these abnormalities could be found in both hemispheres. After treatment, 26.5% of patients recovered completely while 67.7% patients had neurological sequela at different level: memory disorders (58.8%), motor dysfunction (47.1%), language disorders (32.4%). The overall mortality rate was 5.9%.

Conclusions: HSE patients should be early appproched to treatment to limit post-treatment sequelae. Early cranial MRI is a valuable diagnostic method to detect brain lesions in HSE patients.