Can common cold sores cause encephalitis? Maybe – every year in Poland 150 to 200 people get this dangerous form of herpes. The course of the so-called herpetic encephalitis is severe and in many cases ends in death or permanent disability. Unfortunately, knowledge on this subject is still limited.
Marta has been spending another week by the bedside of her 23-year-old daughter. The girl is in the infectious diseases ward of a large city hospital. Martha did not agree to reveal her personal details or the place of treatment of her daughter. It’ll be better for her this way, she thinks.
Her daughter, Jagoda, is a student. Suddenly she fell ill. She came back from sails with friends and, despite the beautiful, sunny aura, complained of a severe cold.
– My husband and I spent most of the time on the plot. Jagoda called us right after returning from vacation. She said she went to bed because her head was hurting and she was breaking her bones. I asked if she had taken the aspirin and if we should go back, but she assured her that she just wanted to warm up and sleep. He asks for peace.
In the following days, the headache did not go away, and Martha’s daughter developed a strong fever. Her upper lip was blistered with herpes. She said the cold threw her out at the beginning of the trip. She believed it was from the sun. She smeared zinc ointment on her lip. She didn’t want to see a doctor.
– I was worried about her, but in the end I talked to an adult – says Marta. – On the fifth day of illness, Jagoda got up quite early, came for breakfast and … fell. She lost consciousness. She has been in a coma since then – Marcie’s voice breaks.
Herpetic encephalitis often begins with infection of the mucosa of the lips, mouth or nose with HSV1, causing the so-called herpes. Herpes often appears in states of weakness of the body and decreased immunity. If left untreated and relapsed, the virus can penetrate the head through the trigeminal plexus, which is directly connected to the skull. The rapidly developing encephalitis may be misinterpreted as symptoms of flu or even migraine!
The blueberry did not show up at the doctor until she lost consciousness. She stated that she had a cold, although the mother admitted in an interview that she had not seen her daughter have a runny nose or a cough. Unfortunately, it also happens that the primary care physician misdiagnoses the symptoms of the disease and delays the implementation of appropriate treatment, which can prove disastrous. If the patient is suggested to have a migraine attack, it is worth remembering that migraine is never accompanied by a fever!
Sometimes herpetic encephalitis develops without any previous changes to the mucosa. It then appears as a set of symptoms that should prompt the patient to see a doctor as soon as possible and demand appropriate tests, such as head tomography and EEG. Symptoms that should awaken alertness are: fever above 38 degrees C, convulsions, disturbed consciousness, paresis of the arm, leg or eyelid, dizziness.
– Apart from a strong fever, dizziness and herpes on the lip, I do not remember that Jagoda had convulsions or body paresis – says Marta – but I have the impression that there was something wrong with her awareness, although it is difficult to describe it, since she returned from vacation she slept most of the time.
– Currently, the daughter is under proper treatment and care, although she was not properly diagnosed immediately. After losing consciousness, a stroke, aneurysm, and even sepsis were found. It took about a week for the doctors to realize it was herpetic encephalitis. And I regret this week because I know how important each hour is in the fight against this terrible disease. Irreversible changes may have already occurred in my daughter’s brain. I pray that she will survive, but in what state she will be after waking up, no one can tell.
Martha learns about the disease from doctors, but she admits that right after the diagnosis, she searched the Internet for information. She read about people who were going through the same thing. She managed to get in touch with the mother of a teenager who had been struggling with the disease for a year.
– It is difficult to reach people who have experienced this disease behind them. 150, 200 people a year is a tiny number compared to other diseases such as cancer. When Karolina’s mother contacted me, I was happy that I would find out first-hand what was happening with her sick child, whether it had recovered. I was shocked when we exchanged e-mails. Karolina was sent home three times by a GP, who took her fever and numbness of her hands down to a cold and… adolescence fatigue. One night, the girl began to suffer from severe vomiting. Mother called an ambulance. They took the girl to the hospital, but the next day they released her home. Nothing was found to be alarming, and the teenagers’ complaints about persistent headaches were interpreted as a severe migraine attack. A few days later, Karolina lost consciousness. Like my daughter. The girl was taken to the hospital ward again. Only then did the proper treatment begin. Currently, Karolina is on the straight. She admitted that before she fell ill, herpes often recurred deep in her nose, which she just scratched off. After encephalitis (it took about a year to heal and recover from the disease!), There is a slight dizziness and words that run away, but the girl’s mother says it’s a piece of cake after what happened at the beginning. Karolina, after a fever of 40 degrees and periodic loss of consciousness, lost her memory. Not completely, but her parents had to teach her many activities from scratch. The girl forgot to read and write, although she had been a good student before. The family also observed slight personality changes. Currently, Karolina is under the constant care of a neurologist and psychologist. The mother assures that without enormous dedication and daily, tedious rehabilitation, the effects that are now would not be possible, although she has heard from doctors about cases of complete recovery without much rehabilitation work. Carolina’s disease slowly but surely subsided, leaving nightmarish memories behind.
For the diagnosis of herpetic encephalitis, cerebrospinal fluid is collected. Increased levels of proteins and leukocytes as well as the presence of antibodies indicate inflammation. In addition, a polymerase chain reaction (PCR) is performed to determine the cause of the infection.
When the herpes virus is the cause of the inflammation, antiviral drugs (including acyclovir) are administered. In other infections, anti-inflammatory corticosteroids and symptomatic treatment are used.
Post-death changes, i.e. problems with body motor skills, memory loss, speech difficulties, etc., are eliminated through rehabilitation. A person with a history of encephalitis should not only be under the constant care of a neurologist, but also a psychologist, because in some cases changes in the personality are observed, as well as depression caused by difficult transitions and the effects of the disease.
Author Ewa Murmiłło