Temporal lobe encephalitis need not always be herpes simplex encephalitis

Think of tuberculosis

Jagadesh Madireddi, Gowtham Reddy, Weena Stanley, Mukhyaprana Prabu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Historically, temporal lobe encephalitis is considered as a pathognomonic feature of Herpes simplex encephalitis. This rule may not always be true and we believe that clinicians should keep their differential open. We here report once such. Case of a 36-year-old Indian male who developed altered sensorium following a prodrome of headache and fever. Examination and imaging suggested Temporal Lobe Encephalitis (TLE). Herpes encephalitis was considered and he was started on anti-virals awaiting lumbar puncture reports. Cerebrospinal fluid (CSF) analysis for Herpes Polymerase Chain Reaction (PCR) turned out to be negative. Later, to our surprise PCR for tuberculosis (TB) was positive. CSF was 100% lymphocytic and Adenosine deaminase was 12. He was started on 5 drug anti-tuberculosis regimen following which he showed a significant clinical improvement. Given the prevalence of tuberculosis in the sub-continent, clinicians must be aware of this diagnostic possibility when a patient with TLE does not respond to anti-virals. Apart from disease specific therapy, multi-disciplinary approach involving speech therapy is warranted. An early aetiological characterization of TLE has both diagnostic and prognostic implications, failing which patient may succumb.

Original languageEnglish
Pages (from-to)OD01-OD02
JournalJournal of Clinical and Diagnostic Research
Volume10
Issue number5
DOIs
Publication statusPublished - 01-05-2016

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Herpes Simplex Encephalitis
Cerebrospinal fluid
Polymerase chain reaction
Encephalitis
Temporal Lobe
Tuberculosis
Adenosine Deaminase
Cerebrospinal Fluid
Speech Therapy
Imaging techniques
Polymerase Chain Reaction
Spinal Puncture
Pharmaceutical Preparations
Headache
Fever

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Madireddi, Jagadesh ; Reddy, Gowtham ; Stanley, Weena ; Prabu, Mukhyaprana. / Temporal lobe encephalitis need not always be herpes simplex encephalitis : Think of tuberculosis. In: Journal of Clinical and Diagnostic Research. 2016 ; Vol. 10, No. 5. pp. OD01-OD02.
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Temporal lobe encephalitis need not always be herpes simplex encephalitis : Think of tuberculosis. / Madireddi, Jagadesh; Reddy, Gowtham; Stanley, Weena; Prabu, Mukhyaprana.

In: Journal of Clinical and Diagnostic Research, Vol. 10, No. 5, 01.05.2016, p. OD01-OD02.

Research output: Contribution to journalArticle

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