Adjunctive Intravenous Immunoglobulin and Glucocorticoid Therapy in Severe Herpes Simplex Encephalitis with Excellent Outcome Begs for Larger Trials Evaluating Immunomodulatory Therapy

George Sakoulas; Jon Roth; Hugo Van der Kuy

doi:10.12659/AJCR.941864

14 January 2024 : Case report USA

Adjunctive Intravenous Immunoglobulin and Glucocorticoid Therapy in Severe Herpes Simplex Encephalitis with Excellent Outcome Begs for Larger Trials Evaluating Immunomodulatory Therapy

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Clinical situation which can not be reproduced for ethical reasons

George Sakoulas^12ABDEF*, Jon Roth^3ABE, Hugo Van der Kuy

^4BCE

DOI: 10.12659/AJCR.941864

Am J Case Rep 2024; 25:e941864

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Figure 2. Case report timeline highlighting: i) early initiation of IVIG and methylprednisolone; ii) continuation of acyclovir beyond the usual 21 days due to persistently positive HSV-1 PCR in CSF; iii) the development of NMDA-receptor antibodies requiring more immunomodulation at 6 weeks. IVIG – intravenous immunoglobulin G; HSV-1 – herpes simplex virus 1; PCR – polymerase chain reaction; CSF, cerebrospinal fluid; NMDA – N-methyl-D-aspartate.

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Adjunctive Intravenous Immunoglobulin and Glucocorticoid Therapy in Severe Herpes Simplex Encephalitis with Excellent Outcome Begs for Larger Trials Evaluating Immunomodulatory Therapy

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