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Brain Biopsy in Herpes Simplex Encephalitis
Author(s) -
Fishman Marvin A.
Publication year - 1992
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1992.tb00970.x
Subject(s) - medicine , brain biopsy , encephalitis , empiric therapy , biopsy , medical diagnosis , empiric treatment , herpes simplex virus , intensive care medicine , pathology , immunology , virus , antibiotics , alternative medicine , microbiology and biotechnology , biology
Routine brain biopsy is often recommended in all patients suspected of having herpes simplex encephalitis (HSE). This approach is based upon the lack of ability to make the diagnosis of HSE on clinical grounds, the need to exclude other diseases for which there is specific therapy, and to stop empiric therapies. Acyclovir is a relatively safe, effective antiviral agent with little toxicity as currently used to treat HSE. Thus this is not a problem. Careful review of alternate diagnoses established at brain biopsy reveals few for which biopsy is the only and best way of making the diagnosis. Thus empiric therapy with acyclovir should be considered in some children in whom all appropriate diagnostic techniques fail to establish specifically treatable diseases. Early detection of HSV antigen in CSF may provide a non‐invasive means of early diagnosis in the future.