感染症と治療ジャーナル

抽象的な

Herpes Simplex Encephalitis in Childhood

Bhagirathi Dwibedi and Sushil Kumar Rathore

Acute Encephalitis Syndrome (AES) is one of the important health problems in childhood that leads to severe morbidity, mortality and sequelae. Herpes Simplex Virus (HSV) attributing towards such viral encephalitis carries importance with respect to its global prevalence challenging pathogenesis and morbidity outcomes. This report provides a review on several studies on epidemiology, pathogenesis (molecular and immune mechanism), clinical presentation, diagnosis and treatment related to Herpes simplex encephalitis (HSE) in children. It highlights wide spread distribution of HSE in children throughout the globe with mortality upto 70% in spite of availability of effective antiviral agent. In this context early diagnosis is a challenge as early CSF studies and imaging may not provide confirmatory diagnosis so an empirical treatment of Acyclovir will be of value. The review pointed that LATs play an important role in molecular modulation but it is still challenging to explain the exact cellular mechanism. The current antivirals available have shown to be potentially useful in curing symptomatic illness but eliminating neuronal carrier stage is still an issue of research for drug development. Better understanding of biochemical and immune response if available can open the scope for use of immunomodulators that can prevent reactivation. This review also focuses upon challenges in immunopathogenesis and treatment and vaccine development.