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Acyclovir resistance in herpes simplex encephalitis
Author(s) -
Schulte Eva C.,
Sauerbrei Andreas,
Hoffmann Dieter,
Zimmer Claus,
Hemmer Bernhard,
Mühlau Mark
Publication year - 2010
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21979
Subject(s) - encephalitis , herpes simplex virus , foscarnet , virology , medicine , alphaherpesvirinae , aciclovir , cerebrospinal fluid , thymidine kinase , virus , herpesviridae , immunology , viral disease , pathology
Herpes simplex virus type 1 is a common cause of severe sporadic encephalitis. Treatment with acyclovir is highly effective in this disease. We report the case of a 27‐year‐old, immunocompetent woman with acyclovir‐resistant herpes simplex encephalitis. Although she had not been treated before, herpes simplex virus type 1 DNA from the cerebrospinal fluid showed a non‐synonymous mutation in the thymidine kinase gene, which is likely to have caused resistance to acyclovir. Herpes simplex encephalitis resolved after treatment with foscarnet. To our knowledge, this is the first report of acyclovir‐resistant herpes simplex virus encephalitis in an immunocompetent, previously therapy‐naive adult. ANN NEUROL 2010;67:830–833