Use of clinical and neuroimaging characteristics to distinguish temporal lobe herpes simplex encephalitis from its mimics

Felicia C. Chow, Carol A. Glaser, Heather Sheriff, Dongxiang Xia, Sharon Messenger, Richard Whitley, Arun Venkatesan

Research output: Contribution to journalArticle

Abstract

Background. We describe the spectrum of etiologies associated with temporal lobe (TL) encephalitis and identify clinical and radiologic features that distinguish herpes simplex encephalitis (HSE) from its mimics. Methods. We reviewed all adult cases of encephalitis with TL abnormalities on magnetic resonance imaging (MRI) from the California Encephalitis Project. We evaluated the association between specific clinical and MRI characteristics and HSE compared with other causes of TL encephalitis and used multivariate logistic modeling to identify radiologic predictors of HSE. Results. Of 251 cases of TL encephalitis, 43% had an infectious etiology compared with 16% with a noninfectious etiology. Of infectious etiologies, herpes simplex virus was the most commonly identified agent (n = 60), followed by tuberculosis (n = 8) and varicella zoster virus (n = 7). Of noninfectious etiologies, more than half (n = 21) were due to autoimmune disease. Patients with HSE were older (56.8 vs 50.2 years; P =. 012), more likely to be white (53% vs 35%; P =. 013), more likely to present acutely (88% vs 64%; P =. 001) and with a fever (80% vs 49%; P

Original languageEnglish (US)
Pages (from-to)1377-1383
Number of pages7
JournalClinical Infectious Diseases
Volume60
Issue number9
DOIs
StatePublished - May 1 2015

Fingerprint

Herpes Simplex Encephalitis
Encephalitis
Temporal Lobe
Neuroimaging
California Encephalitis
Magnetic Resonance Imaging
Human Herpesvirus 3
Simplexvirus
Autoimmune Diseases
Tuberculosis
Fever

Keywords

  • Brain infection
  • Encephalitis
  • Herpes simplex
  • Magnetic resonance imaging
  • Temporal lobe

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Use of clinical and neuroimaging characteristics to distinguish temporal lobe herpes simplex encephalitis from its mimics. / Chow, Felicia C.; Glaser, Carol A.; Sheriff, Heather; Xia, Dongxiang; Messenger, Sharon; Whitley, Richard; Venkatesan, Arun.

In: Clinical Infectious Diseases, Vol. 60, No. 9, 01.05.2015, p. 1377-1383.

Research output: Contribution to journalArticle

Chow, Felicia C. ; Glaser, Carol A. ; Sheriff, Heather ; Xia, Dongxiang ; Messenger, Sharon ; Whitley, Richard ; Venkatesan, Arun. / Use of clinical and neuroimaging characteristics to distinguish temporal lobe herpes simplex encephalitis from its mimics. In: Clinical Infectious Diseases. 2015 ; Vol. 60, No. 9. pp. 1377-1383.
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