Une méningo-encéphalite herpétique à Herpès Simplex Virus de type 2 chez une patiente de 91 ans

We present the case of a 91-year-old woman who was diagnosed with herpetic meningoencephalitis due to HSV2. Complications occurred, with aphasia and an epileptic seizure. Herpetic meningoencephalitis due to HSV2 is a rare illness, and the prognosis can be positive in immunocompetent patients. However, the illness can be more severe for frail patients. The diagnosis should be considered in case of confusion with fever when there is no clinically identified infectious cause, especially if there are focal signs. A firm diagnosis is obtained from HSV2 PCR positivity in the CSF. If there is any suspicion, lumbar puncture should be performed despite the difficulty of this procedure for elderly confused patients. Any delay in diagnosis and in the instatement of treatment exposes the patient to long-term neurological complications. Renal function should be monitored on account of a serious risk of renal failure from acute tubular necrosis. CNS damage resulting from HSV2, the most common cause of aseptic meningitis, has a better prognosis than HSV1, more commonly linked to encephalitis. Herpetic lesions of the skin and mucous tissues are rare.