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HERPES SIMPLEX VIRUS ENCEPHALITIS IN PREGNANCY

From the Department of Obstetrics and Gynecology, Paris XI University, Hôpital Antoine Beclère, Clamart cedex, France.

Address reprint requests to: Olivier Dupuis, MD, Service de Gynecologie, Obstetrique CHU Bichat, 46, rue Henri-Huchard, Paris 75018, France, E-mail: osdupuis{at}club\|[ndash ]\|internet.fr

Background: Although polymerase chain reaction (PCR) can detect herpes simplex virus (HSV) in the cerebrospinal fluid (CSF), HSV encephalitis remains a significant cause of neurologic impairment in pregnant women. Assessment of fetal contamination also remains a problem.

Cases: We report two cases in which HSV encephalitis initially was not suspected and led to significant maternal neurologic impairment. In both cases, HSV PCR of CSF confirmed the diagnosis. In one case, fetal serum HSV PCR excluded fetal contamination.

Conclusion: As soon as encephalitis in pregnancy is suspected, a combination of acyclovir and penicillin is recommended because the potential benefits far outweigh the risks. Using the HSV PCR, HSV infection in the fetus can be diagnosed.

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