What is the mortality rate of herpes simplex encephalitis (HSE)?

Updated: Jul 17, 2018
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Untreated HSE is progressive and often fatal in 7-14 days. A landmark study by Whitley et al in 1977 revealed a 70% mortality in untreated patients and severe neurologic deficits in most of the survivors. [24]

Mortality in patients treated with acyclovir was 19% in the trials that established its superiority to vidarabine. Subsequent trials reported lower mortalities (6-11%), perhaps because they included patients who were diagnosed by polymerase chain reaction (PCR) rather than brain biopsy and who thus may have been identified earlier with milder disease. [1, 3]

The mortality of neonatal HSE is substantial, even with treatment; 6% in patients with isolated HSE and 31% in those with disseminated infection.

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