Cerebral HSV-1 Vasculitis as a Fatal Complication of Immunosuppression in Non-Hodgkin´s Lymphoma: A Case Report and Review of the Literature

Abstract

Patients with lymphoma are predisposed to infection because of the immunocompromised state related to the disease itself and as a consequence of chemo-/radiotherapy. Here, we report a case of Herpes-simplex virus encephalitis (HSE) in an immunosuppressed patient with splenic marginal zone lymphoma (SMZL), a rare indolent variant of non-Hodgkin´s lymphoma (NHL). The course was complicated febrile neutropenia and HSV-1-related cerebral vasculitis causing progressive ischemic stroke. This case illustrates the expanding spectrum of atypical clinical and radiological manifestations of HSE in patients treated with myelotoxic drugs. Moreover, we summarize the few central nervous system manifestations of SMZL reported in the literature and discuss distinct causes of neurological deterioration in patients with NHL.

Biomarkers and Pathogenesis of Infectious and Autoimmune Diseases

“…Infections can be complications of many non-communal diseases. Nardone et al describe a fatal case of a patient with non-Hodgkin´s lymphoma, where immune suppression led to cerebral HSV-1 vasculitis, causing progressive ischemic stroke [ 5 ]. This case report highlights the importance of the monitoring, prophylaxis and timely treatment of infections in immune-suppressed patients.…”