Herpes simplex encephalitis occurring after chemotherapy, surgery, and stereotactic radiotherapy for medulloblastoma

Arch Pathol Lab Med. 2000 Dec;124(12):1809-12. doi: 10.5858/2000-124-1809-HSEOAC.


Reactivation of latent herpes simplex virus (HSV) in the trigeminal ganglion most commonly gives rise to recurrent herpes labialis and rarely to herpes simplex encephalitis. The mechanisms underlying reactivation of latent trigeminal HSV are complex. Here we report the case history of a 25-year-old woman who developed a fatal, bilateral necrotizing destructive temporal lobe lesion following surgical removal of a cerebellar medulloblastoma and combined radiotherapy and chemotherapy for recurrent tumor. Neuropathologic examination of the brain revealed minimal inflammatory changes, but immunohistochemistry was positive for HSV protein, and HSV deoxyribonucleic acid (DNA) was recovered from formalin-fixed paraffin-embedded brain tissue. The temporal proximity of the surgery, chemotherapy, and radiotherapy to the onset of disease suggests that these factors may have acted as triggers that precipitated conversion of latent HSV to overt HSV.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / pathology
  • Brain / virology
  • Cerebellar Neoplasms / complications
  • Cerebellar Neoplasms / surgery
  • Cerebellar Neoplasms / therapy*
  • Combined Modality Therapy / adverse effects
  • DNA, Viral / genetics
  • Drug-Related Side Effects and Adverse Reactions
  • Encephalitis, Viral / etiology*
  • Encephalitis, Viral / pathology
  • Fatal Outcome
  • Female
  • Herpes Simplex / etiology*
  • Herpes Simplex / pathology
  • Humans
  • Medulloblastoma / complications
  • Medulloblastoma / surgery
  • Medulloblastoma / therapy*
  • Polymerase Chain Reaction
  • Radiotherapy / adverse effects
  • Simplexvirus / genetics


  • DNA, Viral