Published online April 10, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. e1045-e1048 (doi:10.1542/peds.2005-1867)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bonkowsky, J. L.
Right arrow Articles by Byington, C. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bonkowsky, J. L.
Right arrow Articles by Byington, C. L.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

EXPERIENCE & REASON

Herpes Simplex Virus Central Nervous System Relapse During Treatment of Infantile Spasms With Corticotropin

Joshua L. Bonkowsky, MD, PhDa, Francis M. Filloux, MDa and Carrie L. Byington, MDb

a Divisions of Pediatric Neurology
b Pediatric Infectious Diseases, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah

ABSTRACT

Here we report an infant who had herpes simplex virus (HSV) encephalitis and sustained severe bilateral damage to the posterior frontal lobes, postcentral gyri, and the thalami despite intravenous acyclovir treatment. At 7 months of age, the patient developed infantile spasms and was treated with corticotropin injections. After 10 days of corticotropin treatment, she developed lethargy, fever, and opisthotonic posturing. Her cerebrospinal fluid again was positive for HSV DNA, indicating recurrent HSV encephalitis, and repeat MRI revealed new lesions of the right frontal, parietal, temporal, and occipital lobes. Immunosuppression by corticotropin may have led to the reactivation of the HSV encephalitis. Corticotropin should be relatively contraindicated for use when a patient has a history of HSV infection, or intravenous acyclovir should be administered concurrently.

Key Words: herpes simplex virus • encephalitis • corticotropin • infantile spasms • relapse • neonatal

Abbreviations: HSV, herpes simplex virus • EEG, electroencephalogram • CNS, central nervous system • CSF, cerebrospinal fluid • WBC, white blood cell • RBC, red blood cell • PCR, polymerase chain reaction

Accepted Oct 24, 2005.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?