ArticleNeurology2012
Atypical manifestations and poor outcome of herpes simplex encephalitis in the immunocompromised.
Article in Neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 4 of them syntheses that pooled it.
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Who cites it
71 citing papers in PubMed, 4 syntheses or guidelines pooled it, 158 citations in OpenAlex.
- Diagnosis and Management of Infectious Encephalitis in Adults: Guidelines From the European Academy of Neurology and European Society of Clinical Microbiology and Infectious Diseases.European journal of neurology · 2026Guideline
- Clinical and Laboratory Predictors of Poor Neurological Outcomes Following Infectious Encephalitis: Systematic Review and Meta-Analysis.European journal of neurology · 2025Pooled it
- Unveiling the clinical spectrum of herpes simplex virus CNS infections in adults: a systematic review.Systematic reviews · 2025Pooled it
- Guideline
- Review
- Herpes Simplex Virus Type 1 Encephalitis: A Prospective Population-Based Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Severe sleep-related hypoventilation in antibody-positive and antibody-negative autoimmune encephalitis: an emergency.The European respiratory journal · 2026Article
- HSV-1 infections of the prefrontal cortex: regional vulnerability, cellular mechanisms, and neurocognitive consequences.Frontiers in cellular neuroscience · 2026Review
- Afebrile HSV-2 Encephalitis with Radiographic Atypia and Minimal Systemic Inflammation: A Case Report.The American journal of case reports · 2025Article
- Health economic impact of early versus delayed treatment of herpes simplex virus encephalitis in the UK.BMJ open · 2025Observational
- Outcomes of Critically Ill Adult Patients With Acute Encephalitis.JAMA network open · 2025Article
- Encephalitis in Immunocompromised vs Immunocompetent Patients: A Comparative Study.Open forum infectious diseases · 2025Article
- Are Glucocorticoids Truly Effective in Improving the Clinical Prognosis of HSV-1 Encephalitis?Infection and drug resistance · 2025Article
- Indirect Immunofluorescence Test for Detecting HSV-1, 2 in Patients with Esophageal Cancer: A Pilot Cross-Sectional Survey in Kazakhstan.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Sociodemographic and Clinical Factors Associated With Clinical Outcome in Neuroinfectious Diseases: A Multicenter Retrospective Cohort Study.The Neurohospitalist · 2024Article
- Herpes Simplex Virus Encephalitis in Patients With Autoimmune Conditions or Exposure to Immunomodulatory Medications.Neurology · 2024Article
- Herpes simplex encephalitis initially presenting without fever or cerebrospinal fluid pleocytosis and with typical neuroimaging findings: a case report.Encephalitis (Seoul, Korea) · 2024Article
- Encephalitis in HIV-negative immunodeficient patients: a prospective multicentre study, France, 2016 to 2019.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- Article
- LC-MS metabolomics and lipidomics in cerebrospinal fluid from viral and bacterial CNS infections: a review.Frontiers in neurology · 2024Review
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Commented on byAuthor response.2013
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo characterize clinical features, neuroimaging, and outcomes of herpes simplex encephalitis (HSE) in immunocompromised individuals.
methodsWe performed a retrospective case control review of patients diagnosed with HSE. Adult patients were dichotomized into immunocompromised (n = 14) and immunocompetent groups (n = 15).
resultsFewer immunocompromised patients presented with prodromal symptoms and focal deficits. While the majority of CSF profiles in the immunocompromised patients were mononuclear cells predominant, 3 had polymorphonuclear predominance and another 3 had normal profiles. MRI showed widespread cortical involvement, with brainstem or cerebellar involvement in some. Two immunocompromised patients had recurrent HSE. The immunosuppressed state was associated with a decrease in Karnofsky Performance Status Scale (KPSS) score of 23.1 (p = 0.018). Every 1-day delay in initiation of acyclovir was associated with a decrease in KPSS of 10.2 (p = 0.002), and every 10 cell/mm(3) increase of CSF leukocytosis was associated with an increase in KPSS of 0.7 (p = 0.009). Mortality rate was 6 times higher in the immunocompromised patients.
conclusionsImmunocompromised states may predispose to HSE with atypical clinical and neuroradiologic features. Immunocompromised individuals with HSE have significantly worse outcomes and mortality. Early diagnosis and treatment is associated with improved outcome. The findings are particularly important in light of the increasing use of potent immunosuppressive and immunomodulatory therapies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.