Post-HSV Autoimmune Encephalitis — SCE Infectious Diseases MCQ

Correct answer: D — Post-HSV autoimmune encephalitis, including CSF and serum neuronal-antibody testing with review after review

The best answer is “Post-HSV autoimmune encephalitis, including CSF and serum neuronal-antibody testing with review after review”. The delayed neuropsychiatric and movement-disorder phenotype with negative viral PCR is characteristic of a post-infectious autoimmune syndrome, commonly anti-NMDAR. “Recurrent HSV proved solely by the old MRI lesion” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Aciclovir nephrotoxicity despite normal renal function” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Uncomplicated delirium requiring no neurological assessment” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Bacterial meningitis caused by the previous lumbar puncture” is less appropriate because it conflicts with the decisive clinical feature or cited guidance.

Reference: Association of British Neurologists/BIA viral encephalitis guideline: https://www.encephalitis.info/professional-guidelines/