In this report we discuss a case of a patient with systemic lupus erythematosus who developed herpes simplex virus type 1(HSV-1) infection presenting with encephalitis as well as necrotic and non-necrotic retinitis. The patient presented with typical clinical symptoms and radiologic abnormalities consistent with HSV-1 encephalitis and HSV-1 retinitis in patients with HIV infection, but lacked cerebrospinal fluid pleocytosis and had bilateral retinitis with poor visual acuity. To the best of our knowledge, this is the first such case reported in the literature.
HanlyJGUrowitzMBSuL. Prospective analysis of neuropsychiatric events in an international disease inception cohort of patients with systemic lupus erythematosus. Ann Rheum Dis2010; 69: 529–535.
2.
YokozekiHOtoyamaKKatayamaI. A case of systemic lupus erythematosus with the central nervous system manifestations (CNS-lupus) mimicking herpes simplex encephalitis (HSE). Nihon Hifuka Gakkai Zasshi1991; 101: 837–842.
3.
Ramos-CasalsMCuadradoMJAlbaP. Acute viral infections in patients with systemic lupus erythematosus: Description of 23 cases and review of the literature. Medicine (Baltimore)2008; 87: 311–318.
4.
LakemanFDWhitleyRJ. Diagnosis of herpes simplex encephalitis: Application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. J Infect Dis1995; 171: 857–863.
5.
AureliusEJohanssonBSköldenbergB. Rapid diagnosis of herpes simplex encephalitis by nested chain reaction assay of cerebrospinal fluid. Lancet1991; 337: 189–192.
6.
KahlonJChatterjeeSLakemanFD. Detection of antibodies to herpes simplex virus in the cerebrospinal fluid of patients with herpes simplex encephalitis. J Infect Dis1987; 155: 38–44.
7.
JakobNJLenhardTSchnitzlerP. Herpes simplex virus encephalitis despite normal cell count in the cerebrospinal fluid. Crit Care Med2012; 40: 1304–1308.
8.
GroverDNewsholmeWBrinkN. Herpes simplex virus infection of the central nervous system in human immunodeficiency virus-type1-infected patients. Int J STD AIDS2004; 15: 597–600.
9.
CinquePVagoLMarenziR. Herpes simplex virus infections of the central nervous system in human immunodeficiency virus-infected patients: Clinical management by polymerase chain reaction assay of cerebrospinal fluid. Clin Infect Dis1998; 27: 303–309.
10.
JamesSHKimberlinDWWhitleyRJ. Antiviral therapy for herpesvirus central nervous system infections: Neonatal herpes simplex virus infection, herpes simplex encephalitis, and congenital cytomegalovirus infection. Antiviral Res2009; 83: 207–213.
11.
AmenábarJJDuránMIMontejoM. Herpes simplex virus encephalitis in a renal transplant patient. Nefrologia2006; 26: 270–273.
12.
GanatraJBChandlerDSantosC. Viral causes of the acute retinal necrosis syndrome. Am J Ophthalmol2000; 129: 166–172.
13.
WongRPavesioCELaidlawDA. Acute retinal necrosis: The effects of intravitreal foscarnet and virus type on outcome. Ophthalmology2010; 117: 556–560.
14.
TibbettsMDShahCPYoungLH. Treatment of acute retinal necrosis. Ophthalmology2010; 117: 818–824.
15.
PalayDASternbergPJr. Decrease in the risk of bilateral acute retinal necrosis by acyclovir therapy. Am J Ophthalmol1991; 112: 250–255.
16.
WensingBde Groot-MijnesJDRothovaA. Necrotizing and nonnecrotizing variants of herpetic uveitis with posterior segment involvement. Arch Ophthalmol2011; 129: 403–408.
17.
AhnMChoNC. Central retinal artery occlusion in herpes zoster ophthalmicus. J Pediatr Ophthalmol Strabismus2002; 39: 123–124.
18.
AtmacaLSOzmertE. Optic neuropathy and central retinal artery occlusion in a patient with herpes zoster ophthalmicus. Ann Ophthalmol1992; 24: 50–53.
19.
ScharfYKrausEZonisS. Optic neuropathy and central retinal artery occlusion in a case of herpes zoster ophthalmicus. Ann Ophthalmol1987; 19: 77–78.
20.
ShahSPHadidOHGrahamEM. Acute retinal necrosis presenting as central retinal artery occlusion with cilioretinal sparing. Eur J Ophthalmol2005; 15: 287–288.
21.
KangSWKimSK. Optic neuropathy and central retinal vascular obstruction as initial manifestations of acute retinal necrosis. Jpn J Ophthalmol2001; 45: 425–428.
22.
YehSFahleGFlaxelCJFrancisPJ. Central retinal vascular occlusion associated with acute retinal necrosis. Arch Ophthalmol2012; 130: 514–517.
23.
OrmerodLDLarkinJAMargoCA. Rapidly progressive herpetic retinal necrosis: A blinding disease characteristic of advanced AIDS. Clin Infect Dis1998; 26: 34–45.