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30 October 2021: Articles

Herpes Simplex Virus Meningoencephalitis Following Pulse-Dose Methylprednisolone: A Case Report and Literature Review

Unusual or unexpected effect of treatment

Jeffrey Horn A , Jon B. Mullholand A , Saad Ashraf A , David Shore A , Andry Van de Louw A*

DOI: 10.12659/AJCR.933847

Am J Case Rep 2021; 22:e933847

Table 1. Summary of reported cases of herpes simplex virus meningoencephalitis associated with steroids administration.

AuthorYearPatient age/sexSteroidDaily dose, (Prednisone equivalent)Duration dIndication for steroidsAssociated risk factorsHSV-1/2LymphopeniaSurvival
Doherty et al []13 200181 y/MHydrocortisone75 mg10Myxedema comaDirect CNS insult due to myxedemaN/AN/ANo
Jacobs []8 199942 y/FDexametha-sone50 mg30Brain metastases (breast)Whole brain radiationN/AN/AN/A
Jaques et al []9 201624 y/MDexametha-sone50 mg8Brain tumorNeurosurgeryHSV-1N/AYes
53 y/MDexametha-sone60 mg18Brain tumorNeurosurgeryHSV-2N/AYes
Tan et al []14 201274 y/FNot specifiedN/AN/APolymyositisCyclophosphamideN/AN/AN/A
Sermer et al []15 201455 y/MDexametha-sone80 mg28Brain metastases (lung)Whole brain radiationHSV-1N/AYes
Bewersdorf et al []16 201960 y/FPrednisolone30 mgN/ACOPD exacerbationIgG deficiencyHSV-1N/AYes
Schiff and Rosenblum []17 199835 y/FDexametha-sone120 mg21CNS lymphomaRadiation/neurosurgeryN/AYesNo
24 y/FDexametha-sone30 mg120GlioblastomaRadiation/neurosurgery/chemotherapyHSV-1YesNo
Alimohamadi et al []6 200422 y/FPrednisolone20 mgN/AUlcerative colitisAzathioprineN/ANoYes
Ng et al []24 201938 y/FNot specifiedN/A8GlioblastomaNeurosurgeryHSV-1NoNo
McLaughlin et al []10 201972 y/MDexametha-sone110 mg4MeningiomaNeurosurgeryHSV-1N/AYes
Osterman et al []18 202048 y/FNot specifiedPulse-dose5Suspected limbic encephalitisNone but CSF abnormalities present before steroid administration (HSV PCR negative)HSV-1N/ANo
Silvano et al []19 200755 y/MDexametha-sone50 mgN/AProphylactic cranial irradiationChemotherapy/radiationHSV-1YesNo
Riel-Romero and Baumann []20 200315 y/MDexametha-sone50 mgN/AGliomaTemozolomide/radiationHSV-1N/AN/A
Peng et al []21 200761 y/MDexametha-sone110 mg14Pituitary adenomaNeurosurgery/radiationN/AYesYes
Wittles et al []12 201162 y/FPrednisolone1 mg/kg/d14PanuveitisAcute retinal necrosisN/AN/ANo
Kim et al []11 201257 y/MMethylpredni-solone1250 mg5Retinal vasculitisAcute retinal necrosisHSV-1N/AYes
Lizarraga et al []22 201332 y/FDexametha-sone110 mg77Glomus jugulare paragangliomaRadiationHSV-1N/AYes
Saito et al []7 201677 y/FDexametha-sone110 mgN/AProphylactic antiemeticChemotherapyHSV-1YesYes
Graber et al []23 201148 y/FDexametha-sone40 mgN/ABrain metastases (lung)Radiation/chemotherapyHSV-2NoYes
55 y/MDexametha-sone80 mgN/ABrain metastases (melanoma)RadiationHSV-1NoNo
45 y/FDexametha-sone50 mgN/AThyroid cancerNeurosurgeryHSV-2NoNo
CNS – central nervous system; COPD – chronic obstructive pulmonary disease; CSF – cerebrospinal fluid; F – Female; HSV – herpes simplex virus; IgG – immunoglobulin G; M – Male; N/A – not available; PCR – polymerase chain reaction.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923