A 50-year-old man presented to the ER with progressive confusion, high fever and somnolence. On examination, patient is confused and hallucinating. After admission, patient develops a tonic-clonic seizure. There is no focal neurological deficit. NCCT head was done and showed no acute bleeding or elevated ICP. CSF analysis shows elevated protein and lymphocytic leukocytosis. MRI brain was done. Which of the following histopathological patterns is most commonly associated with the above condition: –
Correct Answer: <img style="max-width: 100%" src=" />
Description: This is a case of Herpes simplex encephalitis. MRI image shows high signal in right temporal lobe - suggestive of herpes simplex encephalitis. Most common cause HSV-1 EEG abnormalities are seen in temporal lobe. CSF shows elevated protein and lymphocytic leukocytosis. Treatment with acyclovir. MRI shows abnormality in temporal lobes. Option A shows perivascular mononuclear cells and brain necrosis- seen in HSV encephalitis. Option B shows Negri bodies in rabies. Option C shows the classical owl eye appearance seen in CMV encephalitis. Option D shows Schwannoma
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