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Cerebral venous thrombosis: a rare complication of herpes simplex encephalitis

  • M. Vedani
  • O. Toubas
  • M. Hentzien
  • A. Brunet
  • L. Andreoletti
  • F. Bani-SadrEmail author
Case Report
  • 11 Downloads

Abstract

We report a case of classic HSE with early neurological relapse 7 days after onset of acyclovir treatment secondary to cerebral venous thrombosis (CVT). The development of CVT after meningoencephalitis has been described with neurotropic viruses such as HSV, HIV, or enteroviruses and also bacterial or fungal agents. CVT is probably the consequence of the inflammation secondary to these infections. A diagnosis of CVT, although rarely described, should be systematically suspected in patients with HSE who present no or only moderate improvement, or early relapse of symptoms despite adapted acyclovir treatment.

Keywords

Cerebral venous thrombosis Herpes simplex encephalitis Viral encephalitis Encephalitis 

Notes

Author’s contribution

MV collected the data. MV, OT, and FBS wrote the first manuscript draft. All authors were involved in the care of the patient. All authors participated in the interpretation of the data and writing of the final manuscript and all authors approved the final manuscript. FBS was responsible for the overall supervision of the present work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics committee approval

No ethics committee approval was needed.

References

  1. Armangue T, Moris G, Cantarín-Extremera V, Conde CE, Rostasy K, Erro ME, Portilla-Cuenca JC, Turón-Viñas E, Málaga I, Muñoz-Cabello B, Torres-Torres C, Llufriu S, González-Gutiérrez-Solana L, González G, Casado-Naranjo I, Rosenfeld M, Graus F, Dalmau J, Spanish Prospective Multicentric Study of Autoimmunity in Herpes Simplex Encephalitis (2015) Autoimmune post–herpes simplex encephalitis of adults and teenagers. Neurology 85:1736–1743CrossRefGoogle Scholar
  2. Armangue T, Spatola M, Vlagea A, Mattozzi S, Cárceles-Cordon M, Martinez-Heras E, Llufriu S, Muchart J, Erro ME, Abraira L, Moris G, Monros-Giménez L, Corral-Corral Í, Montejo C, Toledo M, Bataller L, Secondi G, Ariño H, Martínez-Hernández E, Juan M, Marcos MA, Alsina L, Saiz A, Rosenfeld MR, Graus F, Dalmau J, Aguilera-Albesa S, Amado-Puentes A, Arjona-Padillo A, Arrabal L, Arratibel I, Aznar-Laín G, Bellas-Lamas P, Bermejo T, Boyero-Durán S, Camacho A, Campo A, Campos D, Cantarín-Extremera V, Carnero C, Conejo-Moreno D, Dapena M, Dacruz-Álvarez D, Delgadillo-Chilavert V, Deyà A, Estela-Herrero J, Felipe A, Fernández-Cooke E, Fernández-Ramos J, Fortuny C, García-Monco JC, Gili T, González-Álvarez V, Guerri R, Guillén S, Hedrera-Fernández A, López M, López-Laso E, Lorenzo-Ruiz M, Madruga M, Málaga-Diéguez I, Martí-Carrera I, Martínez-Lacasa X, Martín-Viota L, Martín Gil L, Martínez-González MJ, Moreira A, Miranda-Herrero MC, Monge L, Muñoz-Cabello B, Navarro-Morón J, Neth O, Noguera-Julian A, Nuñez-Enamorado N, Pomar V, Portillo-Cuenca JC, Poyato M, Prieto L, Querol L, Rodríguez-Rodríguez E, Sarria-Estrada S, Sierra C, Soler-Palacín P, Soto-Insuga V, Toledo-Bravo L, Tomás M, Torres-Torres C, Turón E, Zabalza A (2018) Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. Lancet Neurol 17:760–772CrossRefGoogle Scholar
  3. Bradshaw MJ, Venkatesan A (2016) Herpes simplex Virus-1 encephalitis in adults: pathophysiology, diagnosis, and management. Neurotherapeutics 13:493–508CrossRefGoogle Scholar
  4. Einhäupl K, Stam J, Bousser M-G, De Bruijn SFTM, Ferro JM, Martinelli I et al (2010) EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients: cerebral sinus and venous thrombosis. Eur J Neurol 17:1229–1235CrossRefGoogle Scholar
  5. Ferro JM, Bousser M-G, Canhão P, Coutinho JM, Crassard I, Dentali F, di Minno M, Maino A, Martinelli I, Masuhr F, de Sousa DA, Stam J, for the European Stroke Organization (2017) European stroke organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology. Eur Stroke J 2:195–221CrossRefGoogle Scholar
  6. Kastenbauer S, Pfister H-W (2003) Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. Brain 126:1015–1025CrossRefGoogle Scholar
  7. Lal A, Dhamne MC, Hui AC, Ahmad A (2018) Herpes simplex virus (HSV) encephalitis in a young man: an unusual course. BMJ Case Rep bcr-2017-222499Google Scholar
  8. Meyohas MC, Roullet E, Rouzioux C, Aymard A, Pelosse B, Eliasceiwicz M, Frottier J (1989) Cerebral venous thrombosis and dual primary infection with human immunodeficiency virus and cytomegalovirus. J Neurol Neurosurg Psychiatry 52:1010–1011CrossRefGoogle Scholar
  9. Prendki V, Dumas J-L, Bouges-Michel C, Boch A-L, Bouchaud O, Abgrall S (2008) Cerebral thrombophlebitis as a paradoxical reaction in HIV-patients. AIDS 22:1384–1385CrossRefGoogle Scholar
  10. Pryzdial ELG, Sutherland MR, Ruf W (2014) The Procoagulant envelope virus surface: contribution to enhanced infection. Thromb Res 133:S15–S17CrossRefGoogle Scholar
  11. Rabaud C, Ghiringelli CB, Dauendorffer JN, May T (2002) Echovirus 30 meningitis: a new cause for cerebral venous thrombosis? J Infect 44:53CrossRefGoogle Scholar
  12. Siddiqi SA, Nishat S, Kanwar D, Ali F, Azeemuddin M, Wasay M (2012) Cerebral venous sinus thrombosis: association with primary varicella zoster virus infection. J Stroke Cerebrovasc Dis 21:917.e1–917.e4CrossRefGoogle Scholar
  13. Sinnaeve L, Vanopdenbosch L, Paemeleire K (2017) Association of cerebral venous thrombosis and intracranial hypotension: review of 3 cases. J Stroke Cerebrovasc Dis 26:e165–e169CrossRefGoogle Scholar
  14. Sutherland MR, Raynor CM, Leenknegt H, Wright JF, Pryzdial EL (1997) Coagulation initiated on herpesviruses. Proc Natl Acad Sci USA 94:13510–13514CrossRefGoogle Scholar
  15. Tibussek D, Sinclair A, Yau I, Teatero S, Fittipaldi N, Richardson SE, Mayatepek E, Jahn P, Askalan R (2015) Late-onset group B streptococcal meningitis has cerebrovascular complications. J Pediatr 166:1187–1192.e1CrossRefGoogle Scholar
  16. Wardle M, Mu A, Tong SYC (2018) Streptococcus gallolyticus subsp. pasteurianus meningitis complicated by venous sinus thrombosis: a case report. Int J Infect Dis 71:30–32CrossRefGoogle Scholar
  17. Zuurbier SM, Arnold M, Middeldorp S, Broeg-Morvay A, Silvis SM, Heldner MR, Meisterernst J, Nemeth B, Meulendijks ER, Stam J, Cannegieter SC, Coutinho JM (2016) Risk of cerebral venous thrombosis in obese women. JAMA Neurol 73:579–584CrossRefGoogle Scholar

Copyright information

© Journal of NeuroVirology, Inc. 2019

Authors and Affiliations

  • M. Vedani
    • 1
  • O. Toubas
    • 2
  • M. Hentzien
    • 1
  • A. Brunet
    • 1
  • L. Andreoletti
    • 3
    • 4
  • F. Bani-Sadr
    • 1
    • 4
    Email author
  1. 1.CHU Reims, Unité des Maladies Infectieuses et TropicalesHôpital Robert DebréReimsFrance
  2. 2.Service de RadiologieCHU ReimsReimsFrance
  3. 3.Laboratoire de Virologie Médicale et MoléculaireCHU ReimsReimsFrance
  4. 4.Faculté de médecine, EA-4684/SFR CAP-SANTEUniversité de Reims Champagne-ArdenneReimsFrance

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