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Diagnosis and treatment of herpes simplex encephalitis (HSE) have changed substantially over the past two decades with the introduction of molecular diagnosis and effective therapies. Now, investigators have reviewed their experience with HSE at a large children’s hospital in Toronto.
All children aged 4 weeks to 18 years who presented at this hospital with acute encephalitis from 1994 through 2005 were prospectively enrolled in an encephalitis registry. Of 322 children with nonneonatal encephalitis, 16 (5%) were diagnosed with HSE on the basis of positive herpes simplex virus (HSV) cerebrospinal fluid (CSF) PCR results, a ≥4-fold rise in HSV antibodies, or both, plus evidence of inflammation on examination of CSF or electroencephalographic …