Unusual Suspect After Spinal Anesthesia: Herpetic Encephalitis

Abstract

Herpes simplex virus (HSV) is the most common cause of acute, sporadic viral encephalitis. Usually occurs with the activation of the latent virus. Sudden onset fever and especially temporal lobe involvement are typical clinical features of HSV encephalitis. In this article, we aimed to present a case of herpetic encephalitis, which is an unusual factor in meningitis after spinal anesthesia. Severe headache and convulsion developed at postoperatively. Body temperature of the patient was 38.3 °C and neck stiffness developed. The patient was diagnosed with herpes encephalitis by clinical, laboratory and cranial magnetic resonance, and acyclovir treatment was started immediately. The patient was discharged home with recovery on the 14th day. Loss of consciousness and convulsions with fever seen at the postoperative period after spinal anesthesia, may not always be due to bacterial meningitis but sometimes due to HSV-associated acute herpetic meningoencephalitis. Rapid diagnosis and treatment is life-saving.

Keywords

• acyclovir
• encephalitis
• herpes simplex
• spinal anesthesia