Un herpes pas si simple(x)…

Herpetic meningoencephalitis is a serious infection of the central nervous system. The prognosis depends on the time before introduction of the antiviral therapy. We report a case illustrating the diagnosis and therapeutic pitfalls that may contribute to delay the control of the infection: a misleading clinical presentation by the lack of fever and headache; the absence of meningitis and the negativity of the viral PCR on admission; the ineffectiveness of aciclovir due to insufficient diffusion in the cerebrospinal fluid. The possibility of a virus resistance to aciclovir and a genetic predisposition to herpetic infections are also discussed.