Relapse of herpes encephalitis induced by temozolomide-based chemoradiation in a patient with malignant glioma

Case report

Masaki Okada M.D., Ph.D., Keisuke Miyake M.D., Ph.D., Aya Shinomiya M.D., Nobuyuki Kawai M.D., Ph.D., and Takashi Tamiya M.D., Ph.D.
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  • Department of Neurological Surgery, Kagawa University Faculty of Medicine, Kagawa, Japan
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The authors report on a case of concurrent herpes simplex encephalitis (HSE) and malignant glioma. The co-occurrence of HSE and malignant glioma is very rare, but it can occur during glioma treatment. Both radiotherapy and chemoradiation with temozolomide can induce viral reactivation, leading to HSE relapse. Careful observation for HSE is necessary when administering chemoradiation to patients with a history of HSE. Antiviral therapy for HSE must be initiated immediately, and the chemoradiation for glioma should be stopped; however, it is not clear what antitumor therapy is optimal when HSE co-occurs during the treatment of glioma.

Abbreviations used in this paper:

HSE = herpes simplex encephalitis; HSV = herpes simplex virus; RT-PCR = reverse transcription polymerase chain reaction; TMZ = temozolomide.

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