Image in medicine
Herpes encephalitis
Encefalitis herpética
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"rol" => "short" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 66-year-old female consulted because of behavioural disorders, paraphasia and a week-long fever. History of hypertension and former smoker. On exploration she was found to have temporal-spatial disorientation, drowsiness and no neurological deficit. A computed tomography scan of the brain without contrast was requested, which showed a cortical-subcortical hypodense injury at the left anterior temporal level (Fig. 1, thin arrows). On suspicion of herpetic encephalitis, a lumbar puncture and a brain resonance without contrast were performed. The resonance showed a hyperintense injury in the left temporal region in the T2 sequence (Fig. 2, thick arrow) and the puncture showed a lymphocyte pleocytosis, protein increase and a polymerase chain reaction positive for herpes simplex type 1. We initiated treatment with intravenous acyclovir with favourable evolution.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Herpetic encephalitis is the most common cause of encephalitis. Its clinical symptoms are characterised by fever, headache, seizures, altered consciousness and focal neurological signs. Alterations in the temporal lobe in central nervous system images should make professionals suspect this disease. The lesions are usually unilateral. CT scans have a sensitivity of 50% at the initial stage and magnetic resonance imaging is the most sensitive and specific study. Resonance findings are characterised by high intensity lesions in T2 sequences. Treatment includes systemic acyclovir (10 mg/kg/every 8 h) for between 14 to 21 days.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Castro HM, Chesio HM, de Sanctis GI, Luzzi AA. Encefalitis herpética. Med Clin (Barc). 2019;154:72.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1038 "Ancho" => 900 "Tamanyo" => 80917 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. 1." 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