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Acute hemorrhagic leukoencephalitis mimicking herpes simplex encephalitis: case report
Acute hemorrhagic leukoencephalitis (AHLE) is a more severe form of acute disseminated encephalomyelitis (ADEM) characterized by a fulminant clinical course and the presence of hemorrhagic necrosis of the white matter. We report the case of a 57-year-old woman who developed delirium following a resp...
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| Published in: | Arquivos de neuro-psiquiatria 2004-03, Vol.62 (1), p.139-143 |
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| container_title | Arquivos de neuro-psiquiatria |
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| creator | Martins, Henrique Milhomem Teixeira, Jr, Antônio Lúcio Lana-Peixoto, Marco Aurélio |
| description | Acute hemorrhagic leukoencephalitis (AHLE) is a more severe form of acute disseminated encephalomyelitis (ADEM) characterized by a fulminant clinical course and the presence of hemorrhagic necrosis of the white matter. We report the case of a 57-year-old woman who developed delirium following a respiratory infection. Magnetic resonance imaging of the brain disclosed signal abnormalities in the frontal and temporal lobes, usually found in herpes simplex encephalitis (HSE). Gram stain, India ink and acid-fast bacilli staining were all negative in CSF as was a polymerase chain reaction (PCR) for herpes simplex virus. A diagnosis of AHLE was made and the patient was treated with i.v. methylprednisolone 1g/day for 5 days. Despite treatment, the patient developed several neurological sequelae compatible with the severity of her illness. |
| doi_str_mv | 10.1590/s0004-282x2004000100024 |
| format | article |
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We report the case of a 57-year-old woman who developed delirium following a respiratory infection. Magnetic resonance imaging of the brain disclosed signal abnormalities in the frontal and temporal lobes, usually found in herpes simplex encephalitis (HSE). Gram stain, India ink and acid-fast bacilli staining were all negative in CSF as was a polymerase chain reaction (PCR) for herpes simplex virus. A diagnosis of AHLE was made and the patient was treated with i.v. methylprednisolone 1g/day for 5 days. Despite treatment, the patient developed several neurological sequelae compatible with the severity of her illness.</description><subject>acute disseminated encephalomyelitis</subject><subject>acute hemorrhagic leukoencephalitis</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Diagnosis, Differential</subject><subject>Encephalitis, Herpes Simplex - diagnosis</subject><subject>Encephalitis, Herpes Simplex - drug therapy</subject><subject>Female</subject><subject>Herpes simplex virus</subject><subject>herpes simplex virus encephalitis</subject><subject>Humans</subject><subject>Leukoencephalitis, Acute Hemorrhagic - diagnosis</subject><subject>Leukoencephalitis, Acute Hemorrhagic - drug therapy</subject><subject>Magnetic Resonance Imaging</subject><subject>Methylprednisolone - therapeutic use</subject><subject>Middle Aged</subject><subject>NEUROSCIENCES</subject><subject>PSYCHIATRY</subject><issn>0004-282X</issn><issn>1678-4227</issn><issn>0004-282X</issn><issn>1678-4227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqFkU1v1DAQhi0E6hf8Bcipt239mTjcqgraSpU48CFu1sQe73qbrFM7kcq_x9td2nKBg-UZ-3lfj2cI-cDoGVMtPc-UUrngmj_wEpSElcXlK3L05-Ln6xfxITnOeb0l2rY5IIdMMc6l1Efkx4WdJ6xWOMSUVrAMtupxvou4sTiuoA9TyNUQhmDvwmZZuDRirnIYxh4fqpfUx8pCxirhGNP0lrzx0Gd8t99PyPfPn75dXi9uv1zdXF7cLqykrVwoxSVoB4KDp1x5r5hXVijJpWqsFXUDohYe2tp3FmquFXdOYq07DUoxFCfkZufrIqzNmMIA6ZeJEMzjQUxLA2kKtkeDaFFooToFXjru2pq2jkLXUdk5WtPidbbzyjZgH806zmlTijdft3002z7-1ewiON0JxhTvZ8yTGUK22PewwThn0zCthVDiv2Cx1Y1SdQGbHWhTzDmhf_oSo2Y7-H_U8n7_xNwN6J51-0mL3ycVp2E</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>Martins, Henrique Milhomem</creator><creator>Teixeira, Jr, Antônio Lúcio</creator><creator>Lana-Peixoto, Marco Aurélio</creator><general>Academia Brasileira de Neurologia - ABNEURO</general><general>Academia Brasileira de Neurologia (ABNEURO)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>GPN</scope><scope>DOA</scope></search><sort><creationdate>20040301</creationdate><title>Acute hemorrhagic leukoencephalitis mimicking herpes simplex encephalitis: case report</title><author>Martins, Henrique Milhomem ; 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| language | eng |
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| subjects | acute disseminated encephalomyelitis acute hemorrhagic leukoencephalitis Anti-Inflammatory Agents - therapeutic use Diagnosis, Differential Encephalitis, Herpes Simplex - diagnosis Encephalitis, Herpes Simplex - drug therapy Female Herpes simplex virus herpes simplex virus encephalitis Humans Leukoencephalitis, Acute Hemorrhagic - diagnosis Leukoencephalitis, Acute Hemorrhagic - drug therapy Magnetic Resonance Imaging Methylprednisolone - therapeutic use Middle Aged NEUROSCIENCES PSYCHIATRY |
| title | Acute hemorrhagic leukoencephalitis mimicking herpes simplex encephalitis: case report |
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