Acute herpetic encephalitis with atypical radiological presentation

Abstract

Abstract A 39-year-old male without any preceding medical ailment presented with 12 day history of fever followed by behavioral changes with left sided weakness. He was found to have Herpes Simplex Virus-1 encephalitis (polymerase chain reaction positive) and with Magnetic Resonance Imaging finding of asymmetrical frontotemporoparietal (right side affected more than left side) involvement with patchy enhancement with atypical nodular enhancement and subtle diffusion restriction. Nodular enhancement is rare in acute inflammations and is reported mainly with chronic granulomatous infections.

Keywords

• Atypical nodular enhancement
• HSV-1 encephalitis
• Chronic granulomatous herpetic encephalitis