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Ventral striatal and septal area hypermetabolism on FDG-PET in herpes simplex viral encephalitis

  • T. SinghalEmail author
  • I. Solomon
  • F. Akbik
  • S. Smirnakis
  • H. Vaitkevicius
Case Report
  • 23 Downloads

Abstract

A 71-year-old man presented with sudden onset, generalized tonic-clonic seizures and altered mental status. Initial brain magnetic resonance imaging was normal but a brain FDG-PET scan showed hypermetabolism in the left ventral striatum and septal area. Initial cerebrospinal fluid (CSF) examination showed mildly elevated protein but herpes simplex virus (HSV) polymerase chain reaction (PCR) was negative. A repeat CSF examination performed 9 days later showed a positive HSV PCR. Histopathological and immunohistochemical examination of autopsy specimen confirmed the presence of CD45+ lymphocytes and HSV antigen, suggesting the presence of both inflammation and viral infection corresponding to PET abnormality.

Keywords

Herpes simplex virus Encephalitis PET Fluorodeoxyglucose 

Notes

Acknowledgements

We gratefully acknowledge Prof. Martin A Samuels, MD, and Prof. David Silbersweig, MD, for their intellectual inputs and encouragement.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Journal of NeuroVirology, Inc. 2019

Authors and Affiliations

  1. 1.Department of Neurology, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  2. 2.Department of Pathology, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA

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