We report a unique case of pseudotumour cerebri and
herpes encephalitis resulting due to isotretinoin.
Although a diagnosis of
herpes encephalitis may be confirmed by polymerase chain reaction (PCR), a comprehensive evaluation, including clinical findings, imaging, electroencephalography, and cerebrospinal fluid (CSF) results, should be performed to reach a possible diagnosis of PCR-negative viral encephalitis or another alternative diagnosis in cases with HSE-resembling encephalitis.
Caption: Figure 2: Coronal T2W-Fast spin echo (FSE) image showing hyper-intensity in the deep white matter of left temporal lobe with cortical thickening suggestive of
Herpes encephalitis.
Little et al., "Chronic cortical and subcortical pathology with associated neurological deficits ensuing experimental
herpes encephalitis," Brain Pathology, vol.
Kawakami et al., "A case of fatal
herpes encephalitis presenting massive cerebral hematoma," No Shinkei Geka.
Herpes encephalitis is the most common sporadic cause of encephalitis worldwide.
Previously reported cases have demonstrated the ability of Gliomatosis Cerebri to mimic infective lesions such as acute diffuse encephalomyelitis, tuberculosis, Creutzfeldt-Jakob disease, and
herpes encephalitis. Although multifocal GBM can theoretically present as an infectious lesion, it is far less likely than Gliomatosis Cerebri to present in this fashion.
Fluid attenuated inversion recovery (FLAIR) MRI of
herpes encephalitis. J Comput Assist Tomogr.
Initial treatment included broad-spectrum antibiotics for presumed sepsis and acyclovir for suspected
herpes encephalitis.
Fluid attenuated inversion recovery (FLAIR), MRI of
herpes encephalitis. J Comput Assist Tomogr 1995; 19:501-505.
A neuropsychiatry assessment confirmed that this lady had acquired brain injury following
Herpes encephalitis. Single photon emission computed tomography (SPECT) showed extensive brain injury consistent with HSV.