Herpes Simplex Virus and Tuberculosis-Associated Encephalitis in Northeast of Iran

Encephalitis is associated with high rates of mortality and morbidity; however, its pathophysiology is yet to be determined. A prospective cohort study of patients with clinically diagnosed encephalitis was performed to investigate herpes simplex virus (HSV) or tuberculosis infection in encephalitis patients. Overall, 114 patients were enrolled according to clinical profile and were tested for the presence of HSV-1 and 2 or tuberculosis using TaqMan real-time PCR method on cerebrospinal fluid (CSF). Thirty patients were clinically diagnosed with HSV infection, whose CSF samples were sent for HSV qRT-PCR test. The results showed that 10 (33.3%) subjects were HSV-1 or 2-positive. Out of 84 patients who were tested for tuberculosis encephalitis, and tuberculosis qRT-PCR was carried out on their CSF, 3 (3.6%) cases were positive. No significant differences were found in gender and age between HSV or tuberculosis-negative and positive groups. The main symptoms in HSV positive subjects were fever and depressed level of consciousness. No cases of tuberculosis infection were diagnosed in direct CSF smear test. Since infectious encephalitis is a life-threatening problem and tuberculosis and HSV are progressing in the developing countries, health authorities, physicians and researchers should address this problem more seriously