IPLab:Lab 8:HSV Encephalitis

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Clinical Summary

This 30-year-old white male experienced a generalized tonic-clonic seizureA tonic-clonic seizure involves loss of consciousness followed by tonic, then clonic, convulsions. and was subsequently started on a course of Dilantin. He did well, but later developed a headache lasting over a week, which was associated with tonic-clonic seizuresA tonic-clonic seizure involves loss of consciousness followed by tonic, then clonic, convulsions., fever, and--toward the end of this period--ataxia. The patient improved and returned to work, but the headache returned. A lumbar puncture was then performed which showed 22 cells/mm³A normal number of cells in CSF is <4 lymphocytes per mm³. (all lymphocytes), protein of 88 grams/LA normal protein level for CSF should be < 0.4 grams/L., and a glucose level of 49 mg/dLA normal CSF glucose level should be approximately 70% of the patient's serum glucose level. (with a simultaneous serum glucose of 83 mg/dL). These findings were compatible with a viral infection. Despite therapy, the patient had another seizure and again developed fever. At that time, a brain biopsy was performed which showed herpetic encephalitis. Despite aggressive antiviral therapy the patient died.

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