Post-operative Encephalitis after Surgical Resection of Meningioma

Abstract

Intracranial infections following neurosurgery are most commonly caused by bacteria. Postoperative herpes simplex encephalitis has been described but rare. Herpes simplex virus (HSV) encephalitis is a life-threatening consequence of HSV infection of the central nervous system. Although HSV encephalitis is rare, mortality rates reach 70 per cent in the absence of therapy and only a minority of individuals return to normal function. Antiviral therapy is most effective when started early. In our case report, impairment of consciousness and hypertone of arms and legs complicated the post-operative course in a patient who underwent surgical removal of a meningioma. Brain magnetic resonance imaging (MRI) and computed tomography scans performed after onset of symptoms of infection suggested HSV encephalitis, and polymerase chain reaction identification of HSV 1 DNA confirmed the diagnosis.