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Korean J Med > Volume 88(5); 2015 > Article
The Korean Journal of Medicine 2015;88(5): 602-607.
비인두암 환자 중 동시항암화학방사선요법 후 발생한 단순 헤르페스 뇌염
최혜진1, 이지은1, 홍숙희1, 전은경1, 이시원2, 김연실2, 강진형1
1가톨릭대학교 의과대학 서울성모병원 종양내과
2가톨릭대학교 의과대학 서울성모병원 방사선종양학과
Herpes Simplex Encephalitis after Concurrent Chemoradiotherapy in Nasopharyngeal Cancer: A Case Report
Hye Jin Choi1, Jieun Lee1, Suk Hee Hong1, Eun Kyung Jeon1, Seawon Lee2, Yeon Shil Kim2, Jin Hyoung Kang1
1Division of Medical Oncology, Departments of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Departments of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding Author: Jin Hyoung Kang ,Tel: +82-2-2258-6043, Fax: +82-2-594-6043, Email: jinkang@catholic.ac.kr
Received: February 3, 2014;   Revised: April 1, 2014;   Accepted: May 16, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Herpes simplex encephalitis (HSE) is a rare viral encephalitis in adults. A high (70%) mortality rate with serious complications has been reported even after active, appropriate management. The association between HSE and immune suppression is unclear, but there are case reports of cancer patients in which HSE concomitantly developed after whole brain radiation or high-dose steroid treatment. The clinical manifestations and laboratory findings of these patients are atypical compared to the general population. Although brain magnetic resonance images reveal typical HSE findings, cerebrospinal fluid (CSF) analysis might be normal in cancer patients. We report a case of HSE in a 48-year-old male diagnosed with nasopharyngeal cancer and treated with concurrent chemoradiation. This patient had a normal cell count in CSF, but HSE was finally diagnosed from positive polymerase chain reaction test results. After administration of acyclovir and systemic steroid treatment, the patient had a good clinical course with few neurologic sequelae.
Keywords: Herpes simplex encephalitis; Nasopharyngeal cancer; Chemoradiotherapy
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