Herpes Simplex Encephalitis Occurring During Chemo-Radiotherapy in Nasopharyngeal Carcinoma – A Case Report from Saudi Arabia
Khalid Riaz
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Muhammad M Fareed *
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Muhammad Shuja
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Farhan Khalid
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Mutahir Tunio
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Rashad Akasha
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Abdullah Al Amro
Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Aim: To see possible association between the chemotherapy, radiotherapy or both with the reactivation of Herpes simplex virus 1(HSV1) in brain which merits further dialogue in the field of current evidence based literature.
Presentation of Case: We present a case of 46 years old male patient who developed herpes simplex encephalitis (HSE) while receiving radical chemo-radiation for locally advanced nasopharyngeal carcinoma. Full informed consent was obtained for publication of this case. He was treated with protracted course of anti-virals and is currently leading a healthy life.
Study Design: The study is a case report of a rare but important side effect of a common chemoradiation procedure.
Place and Duration of Study: The study took place at Comprehensive Cancer Center, King Fahad Medical City. It was reported during June 2013.
Discussion: HSV1 causes several disseminated primary infections including herpes labialis, gingivostomatitis, and corneal infections. It is particularly notorious for causing potentially fatal encephalitis. Its reactivation is linked to several environmental factors including chemotherapy and radiotherapy.
Conclusion: This case report emphasizes on the possible role of chemo-radiation as causation of this life threatening condition, its early detection, prompt and aggressive treatment.
Keywords: Herpes simplex encephalitis (HSE, chemo-radiation in nasopharyngeal carcinoma, latent herpes simplex virus-1 (HSV-1)