Case Report
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A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis

Year 2023, Volume: 14 Issue: 4, 81 - 83, 31.12.2023
https://doi.org/10.33706/jemcr.1325932

Abstract

Herpes simplex viruses (HSVs) belong to the Herpesviridae family. Close contact is the primary mode of transmission for both HSV-1 and HSV-2, leading to a persistent lifelong infection. HSVs are widely recognized as causative agents of viral infections affecting the central nervous system, capable of presenting as both meningitis and encephalitis. Herpes simplex virus type 1 (HSV-1) is the predominant viral cause of encephalitis, accounting for the majority of cases. Here, a rare co-infection case of meningoencephalitis, associated with HSV-1 and rickettsia is described. A 42-year-old man presenting with non-remitting headache for 6 days, fever, sweating, and muscle aches was admitted to the Emergency Department. His Weil-Felix test was positive for Proteus OX2 indicating rickettsial infection. Therapy started promptly however patient’s condition deteriorated. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, and elevated protein concentration. CSF molecular analysis was positive for HSV-1. His cranial MRI indicated cytotoxic edema and gyral enhancement at the right temporal lobe. He was administered acyclovir for 14 days during hospital stay and was successfully discharged. This case report highlights that HSV-1 meningoencephalitis can co-occur with rickettsia infection in immunocompetent individuals, and co-infection with other agents should always be considered to avoid the progression of the disease.

References

  • Whitley R, Baines J. Clinical management of herpes simplex virus infections: past, present, and future. F1000Res. 2018; 7:F1000 Faculty Rev-1726.
  • James C, Harfouche M, Welton NJ, Turner KM, Abu-Raddad LJ, Gottlieb SL, Looker KJ. Herpes simplex virus: Global infection prevalence and incidence estimates, 2016. Bull World Health Organ. 2020; 98(5):315–329.
  • Whitley, R.J. Herpes simplex encephalitis: Adolescents and adults. Antiviral Res.2006;71(2–3):141–148.
  • Hjalmarsson A, Blomqvist P, Sköldenberg B. Herpes simplex encephalitis in Sweden. 1990–2001: incidence, morbidity, and mortality. Clin Infect Dis. 2007;45(7):875–80.
  • Spernovasilis N, Markaki I, Papadakis M, Mazonakis N, Ierodiakonou D. Mediterranean Spotted Fever: Current Knowledge and Recent Advances. Trop Med Infect Dis. 2021; 24;6(4):172.
  • Guvenir M, Guler E, Suer K. Could the SARS-CoV-2 Outbreak Cause an Increase in Rickettsia Infection? North Cyprus Observation. Mid Blac Sea Journal of Health Sci. 2022;8(2): 314-319.
  • Sekeyová Z, Danchenko M, Filipčík P, Fournier PE. Rickettsial infections of the central nervous system. PLoSNegl Trop Dis. 2019;29;13(8):e0007469.
  • Leuci S, Coppola N, Cantile T, Calabria E, Mihai LL, Mignogna MD.Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports. Int J Environ Res Public Health. 2022;19(3919):1-17.
  • Sanaee L, Taljaard M, Karnauchow T, Perry JJ. Clinical and Laboratory Findings That Differentiate Herpes Simplex Virus Central Nervous System Disease from Enteroviral Meningitis. Can J Infect Dis Med Microbiol. 2016;2016:(3463909):1-8.
  • Nilsson K, Wallmenius K, Pahlson C. Coinfection with Rickettsia Helvetica and Herpes Simplex Virus 2 in a Young Woman with Meningoencephalitis. Case Rep Infect Dis.2011;2011:469194.
Year 2023, Volume: 14 Issue: 4, 81 - 83, 31.12.2023
https://doi.org/10.33706/jemcr.1325932

Abstract

References

  • Whitley R, Baines J. Clinical management of herpes simplex virus infections: past, present, and future. F1000Res. 2018; 7:F1000 Faculty Rev-1726.
  • James C, Harfouche M, Welton NJ, Turner KM, Abu-Raddad LJ, Gottlieb SL, Looker KJ. Herpes simplex virus: Global infection prevalence and incidence estimates, 2016. Bull World Health Organ. 2020; 98(5):315–329.
  • Whitley, R.J. Herpes simplex encephalitis: Adolescents and adults. Antiviral Res.2006;71(2–3):141–148.
  • Hjalmarsson A, Blomqvist P, Sköldenberg B. Herpes simplex encephalitis in Sweden. 1990–2001: incidence, morbidity, and mortality. Clin Infect Dis. 2007;45(7):875–80.
  • Spernovasilis N, Markaki I, Papadakis M, Mazonakis N, Ierodiakonou D. Mediterranean Spotted Fever: Current Knowledge and Recent Advances. Trop Med Infect Dis. 2021; 24;6(4):172.
  • Guvenir M, Guler E, Suer K. Could the SARS-CoV-2 Outbreak Cause an Increase in Rickettsia Infection? North Cyprus Observation. Mid Blac Sea Journal of Health Sci. 2022;8(2): 314-319.
  • Sekeyová Z, Danchenko M, Filipčík P, Fournier PE. Rickettsial infections of the central nervous system. PLoSNegl Trop Dis. 2019;29;13(8):e0007469.
  • Leuci S, Coppola N, Cantile T, Calabria E, Mihai LL, Mignogna MD.Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports. Int J Environ Res Public Health. 2022;19(3919):1-17.
  • Sanaee L, Taljaard M, Karnauchow T, Perry JJ. Clinical and Laboratory Findings That Differentiate Herpes Simplex Virus Central Nervous System Disease from Enteroviral Meningitis. Can J Infect Dis Med Microbiol. 2016;2016:(3463909):1-8.
  • Nilsson K, Wallmenius K, Pahlson C. Coinfection with Rickettsia Helvetica and Herpes Simplex Virus 2 in a Young Woman with Meningoencephalitis. Case Rep Infect Dis.2011;2011:469194.
There are 10 citations in total.

Details

Primary Language English
Subjects Infectious Diseases
Journal Section Case Report
Authors

Buket Baddal 0000-0003-3319-2179

Aysegul Bostancı 0000-0003-4319-9032

Tutku Aksoy 0009-0000-0106-5402

Yasemin Kucukciloglu 0000-0002-1572-1375

Kaya Süer 0000-0002-2565-3425

Publication Date December 31, 2023
Submission Date July 11, 2023
Published in Issue Year 2023 Volume: 14 Issue: 4

Cite

APA Baddal, B., Bostancı, A., Aksoy, T., Kucukciloglu, Y., et al. (2023). A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis. Journal of Emergency Medicine Case Reports, 14(4), 81-83. https://doi.org/10.33706/jemcr.1325932
AMA Baddal B, Bostancı A, Aksoy T, Kucukciloglu Y, Süer K. A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis. Journal of Emergency Medicine Case Reports. December 2023;14(4):81-83. doi:10.33706/jemcr.1325932
Chicago Baddal, Buket, Aysegul Bostancı, Tutku Aksoy, Yasemin Kucukciloglu, and Kaya Süer. “A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-Infection in a Male Patient With Meningoencephalitis”. Journal of Emergency Medicine Case Reports 14, no. 4 (December 2023): 81-83. https://doi.org/10.33706/jemcr.1325932.
EndNote Baddal B, Bostancı A, Aksoy T, Kucukciloglu Y, Süer K (December 1, 2023) A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis. Journal of Emergency Medicine Case Reports 14 4 81–83.
IEEE B. Baddal, A. Bostancı, T. Aksoy, Y. Kucukciloglu, and K. Süer, “A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis”, Journal of Emergency Medicine Case Reports, vol. 14, no. 4, pp. 81–83, 2023, doi: 10.33706/jemcr.1325932.
ISNAD Baddal, Buket et al. “A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-Infection in a Male Patient With Meningoencephalitis”. Journal of Emergency Medicine Case Reports 14/4 (December 2023), 81-83. https://doi.org/10.33706/jemcr.1325932.
JAMA Baddal B, Bostancı A, Aksoy T, Kucukciloglu Y, Süer K. A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis. Journal of Emergency Medicine Case Reports. 2023;14:81–83.
MLA Baddal, Buket et al. “A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-Infection in a Male Patient With Meningoencephalitis”. Journal of Emergency Medicine Case Reports, vol. 14, no. 4, 2023, pp. 81-83, doi:10.33706/jemcr.1325932.
Vancouver Baddal B, Bostancı A, Aksoy T, Kucukciloglu Y, Süer K. A Rare Case of Rickettsia and Herpes Simplex Virus 1 Co-infection in a Male Patient with Meningoencephalitis. Journal of Emergency Medicine Case Reports. 2023;14(4):81-3.