Herpes simplex encephalitis complicated with vasculitis in a young Male: A case report

We present a case of a 28-year-old male who presented with a five-day history of headache, fatigue, and behavioral abnormalities.Brain MRI, EEG, and CSF investigation all indicated Herpes Simplex encephalitis.Vasculitis complicating encephalitis was diagnosed after he suffered deterioration in his neurologic status with new imaging findings. ConclusionA rare but possible consequence of herpes simplex encephalitis in patients who do not exhibit clinical improvement or worsening of symptoms in the weeks following treatment is HSV 1-associated vasculitis leading to ischemic stroke.Early diagnosis is made possible by imaging examinations done as early as possible, and considering empirical steroid treatment has paramount importance as it improves outcomes. Key Note MessageHigh Index of suspicion for HSV related CNS vasculitis is imperative especially to patients diagnosed with HSV vasculitis where the clinical symptoms are either not improving or worsening in despite treatment with anti-viral agents.Basic brain imagings are crucial especially in resource-limited settings where vascular imaging is not readily available.Treatment with steroids empirically can also be valuable as it prevents further complications.