A Case Report of herpes encephalitis and COVID-۱۹

Introduction: The co-occurrence of herpes simplex encephalitis and COVID-۱۹ presents a significant diagnostic and therapeutic challenge. This article reports a rare case of this dual infection and highlights the importance of timely diagnosis and treatment.  Case Report: A ۴۰-year-old woman with a history of hypertension presented to the emergency department with fever, headache, and two episodes of tonic-clonic seizures. Investigations revealed hypoxemia (SpO₂=۸۹%) and CT/MRI findings consistent with herpes encephalitis (bilateral temporal and frontal lobe lesions). A positive PCR test and pulmonary imaging confirmed concurrent COVID-۱۹. Treatment with intravenous acyclovir, phenytoin, and supplemental oxygen led to complete clinical recovery within ۷۲ hours.  Discussion: This case highlights three key points: the necessity of considering non-COVID etiologies for acute neurological symptoms in COVID-۱۹ patients, the potential increased risk of HSV reactivation due to COVID-۱۹-induced immune suppression or physiological stress, and the critical importance of empirical antiviral therapy before laboratory confirmation in suspected cases.  Conclusion: Herpes simplex encephalitis should be included in the differential diagnosis of neurological manifestations in COVID-۱۹ patients, particularly those presenting with seizures and altered consciousness. Rapid diagnostic evaluation and early treatment initiation can significantly improve clinical outcomes.

کلیدواژه ها:

Encephalitis ، Pandemic ، COVID-۱۹ ، Herpes Simplex