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March 4, 1968


JAMA. 1968;203(10):882-883. doi:10.1001/jama.1968.03140100064017

Herpes simplex virus, the ubiquitous agent that causes cold sores, has recently been recognized as the single commonest cause of fatal non-epidemic encephalitis in this country. In a recent issue of the Archives of Neurology, Johnson et al1 present a reappraisal of the laboratory methods employed in the diagnosis of herpes simplex virus infections of the nervous system. They find that diagnostic criteria have not been sufficiently stringent, and they conclude that serologic tests are of very limited value, since increases in antibody may be prompted by unrelated diseases which reactivate the latent herpes simplex virus. Pathologic findings of localized necrosis of orbital-frontal and medial-temporal lobes of the brain coupled with the finding of intranuclear inclusion bodies probably justify a presumptive diagnosis of herpesvirus encephalitis, but neither the unique localization nor the inclusions are invariably present. They conclude that the only methods which provide a definitive diagnosis are the