KẾT QUẢ ĐIỀU TRỊ VIÊM NÃO DO HERPES SIMPEX VIRUS TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG GIAI ĐOẠN 2018-2022

Abstract

Objectives: To evaluate the outcome of herpes simplex encephalitis in patients treated at National hospital for Tropical Diseases. Methods: A retrospective cross-sectional study on  66 patients who were ≥ 18 years, treated at National Hospital of Tropical Diseases from 01 July 2018 to 30 Juin 2021. Patients were included if they had clinical symptoms of meningoencephalitis and confirmed by detection of HSV deoxyribonucleic acid in the CSF using PCR test. Results: Average time from the onset to the treatment with Acyclovir was 6.7 days (2-29 days). After 2 weeks of treatment, CSF were improved both white blood cells and protein (85.4% and 58.5%, respectively), 21 of 22 patients (95.5%) had PCR test negative with HSV. 24 patients (36.4%) were treated in ICU. The mortality rate is 6.1%.  At the time of discharge, 28.8% of patients were completely cured, 43 patients (65.1%) had sequelae, most of sequelae were moderate and severe. Severe neurological sequelae are memory disorder (55.8%), motor deficits (53.5%), language disorder (30.2%). Conclusions: The proportion of sequelaes post herpetic encephalitis are still high, it may be caused by late treatment. Therefore, it is necessaire to give Acyclovir to patients who are suspected with HSV encephalitis as soon as possible. The duration of treatment must be longer than 2 weeks for CSF normalization.