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Case Reports in Medicine
Volume 2012, Article ID 241710, 3 pages
http://dx.doi.org/10.1155/2012/241710
Case Report

An Unusual Presentation of Herpes Simplex Virus Encephalitis

1Department of Medicine, Austin Health, Studley Road, Heidelberg, VIC 3084, Australia
2Department of Psychiatry, Austin Health, Studley Road, Heidelberg, VIC 3084, Australia
3Department of Emergency Medicine, Austin Health, Studley Road, Heidelberg, VIC 3084, Australia
4Departments of Infectious Diseases and Microbiology, Austin Health, Studley Road, Heidelberg, VIC 3084, Australia
5Department of Medicine, The University of Melbourne, Melbourne, VIC 3010, Australia

Received 14 May 2012; Revised 24 July 2012; Accepted 11 August 2012

Academic Editor: Larry W. Moreland

Copyright © 2012 Ray Boyapati et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of a 65-year-old man with an acute alteration in mental state that was initially diagnosed as a functional psychiatric condition. After extensive workup, herpes simplex virus type 1 (HSV-1) was detected in the patient’s cerebrospinal fluid (CSF) by polymerase chain reaction (PCR), and he responded rapidly to treatment with acyclovir. The case illustrates the importance of actively excluding organic causes in such patients, the need to have a low threshold of suspicion for HSV encephalitis, and the central role of CSF PCR testing for the diagnosis of HSV encephalitis, even in the absence of CSF biochemical abnormalities.