Laboratory Examination for Herpes Simplex Encephalitis
CSS Analysis: Typically shows mononuclear pleocytosis with a mild increase in protein levels while the glucose levels normal or decreased slightly. In the early phases of disease, sometimes cell count may be normal, although on serial examination always found an increasing number of cells and proteins. If there is bleeding in the brain parenchyma, the number of erythrocytes is always increasing and the increase was settled on the all tube inspection. HSV CSF culture is rarely found in patients with HSE.
PCR: PCR analysis of CSF is sensitive and specific for diagnosis of HSE, although already received antiviral therapy. In fulfilling standard diagnostic criteria, PCR can be replaced with brain tissue biopsy. PCR results are available within 24 hours since the CSS examination. With current methods, the results already obtained even <4 hours. PCR is an examination of a relatively quick and easy to detect the virus in vitro are usually only seen in a small specimen of the patient. With PCR showed viral DNA replication activity. PCR was not performed routinely on CSF examination, inspection is only done if there is suspicion of HSE. HSV DNA is very stable with freezing, refrigeration or room temperature storage in the CSS. Therefore, checks can be done several days or several weeks after the specimen was taken.CSS Analysis: Typically shows mononuclear pleocytosis with a mild increase in protein levels while the glucose levels normal or decreased slightly. In the early phases of disease, sometimes cell count may be normal, although on serial examination always found an increasing number of cells and proteins. If there is bleeding in the brain parenchyma, the number of erythrocytes is always increasing and the increase was settled on the all tube inspection. HSV CSF culture is rarely found in patients with HSE.
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HSE Radiological Examination