Herpes simplex encephalitis

Herpes simplex encephalitis

ARTICLES 17 Walter SD. The estimation and interpretation of attributable risk in health research. Biometrics 1976; 32: 829–49. 18 Greenland S. Quanti...

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17 Walter SD. The estimation and interpretation of attributable risk in health research. Biometrics 1976; 32: 829–49. 18 Greenland S. Quantitative methods in the review of epidemiologic literature. Epidemiol Rev 1987; 9: 1–30. 19 Greenland S. Bias in methods for deriving standardised morbidity ratio and attributable fraction estimates. Stat Med 1984; 3: 131–41. 20 Mathers CD. Health expectancies: an overview and critical appraisal. In: Murray CJL, Salomon JA, Mathers CD, Lopez AD, eds. Summary measures of population health: concepts, ethics, measurement and applications. Geneva: WHO, 2002: 177–204. 21 Mathers CD, Sadana R, Salomon JA, Murray CJL, Lopez AD. Healthy life expectancy in 191 countries, 1999. Lancet 2001; 357: 1685–91.

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Clinical picture Herpes simplex encephalitis Zhiping Hu, Qidong Yang, Xiao Bo, Jinghe Li

A 13-year-old boy presented with vomiting, weakness, and fever. He had a raised white blood cell count, and developed somnolence, dysarthria and confusion after 3 days of hospitalisation. We did a lumbar punture and measured an opening pressure of 205 mm H20, a cerebrospinal fluid protein content of 0·78 g/L and positive IgM antibody to herpes simplex virus type 1. Contrast-enhanced cerebral magnetic resonance imaging done 8 days after onset showed bilateral, symmetrical areas of hyperintensity in the basal ganglia, morphologically superimposable upon the two segments of the globus pallidus (figure). We gave the patient acyclovir for 2 weeks, and he recovered gradually over the following 4 months. Department of Neurology, Second Xiangya Hospital (Z Hu MD), and Xiangya Hospital (Q Yang MD, X Bo MD); Department of Pathology (J Li MD); Central South University, Changsha, 410011, China

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THE LANCET • Vol 361 • July 26, 2003 • www.thelancet.com

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