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Volume 7, Issue 11

Herpes simplex virus type 2 implicated in a case of acute disseminated encephalomyelitis Open Access

Abstract

Acute disseminated encephalomyelitis (ADEM) is a well-described neurological disorder that follows acute infection, vaccination and organ transplantation. It is characterized by sudden and widespread areas of inflammation in the central nervous system. Previous case reports have described ADEM with evidence of either recent or current herpes simplex virus type 1 infection. However, here, we report a rare, to our knowledge never before documented, case of ADEM associated with herpes simplex virus type 2 (HSV-2).

A 20-year-old man presented with weakness and sensory disturbance to the lower limbs, which had gradually progressed over the preceding 7 days, with associated fever, urinary retention and bowel incontinence. Magnetic resonance imaging was in keeping with a diagnosis of ADEM with mainly spinal involvement. Lumbar puncture revealed lymphocytic pleocytosis with elevated protein, and PCR was strongly positive for HSV-2. He was treated with aciclovir and dexamethasone, along with broad-spectrum antibiotics until negative bacterial and mycobacterial culture results were obtained. His functional status improved over the following months, but, despite prolonged rehabilitation, neurological sequelae remain.

HSV-2 may be considered a possible aetiological agent in cases of ADEM.

  • Received:
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  • Published Online:
Keyword(s): acute disseminated encephalomyelitis (ADEM) and herpes simplex virus type 2 (HSV-2)
© 2025 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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2025-11-17
2025-12-16

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Herpes simplex virus type 2 implicated in a case of acute disseminated encephalomyelitis
Access Microbiology 7, 001018.v3 (2025); https://doi.org/10.1099/acmi.0.001018.v3
/content/journal/acmi/10.1099/acmi.0.001018.v3
/content/journal/acmi/10.1099/acmi.0.001018.v3
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