SONOGRAPHY IN HERPES-ENCEPHALITIS

We present the case of an eleven months old infant, who suffered from herpes simplex type I encephalitis. Cerebral ultrasound examination showed on 5th day of disease signs of focal echodensity. At that time CT showed a focal meningeal enhancement and CSF findings were normal. Suspicions changes were also obtained by MR-Imaging and EEG on the same day. Herpes simplex virus was identified in the CSF with Polymerasechainreaction days later. There are no typical clinical signs for herpes encephalitis, CT, NMR, EEG findings as well as antigen and antibody-tests do naturally take their time. Cerebral sonography in infants offers to be the best bed-side methode for early suspicion of herpes encephalitis, which may support diagnostic workup and can help to start a specific therapy (Acyclovir) as soon as possible.