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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2025; 13(34): 111438
Published online Dec 6, 2025. doi: 10.12998/wjcc.v13.i34.111438
Published online Dec 6, 2025. doi: 10.12998/wjcc.v13.i34.111438
Recurrence of acyclovir-resistant herpes encephalitis in an immunocompromised patient: A case report
Daisuke Usuda, Daiki Furukawa, Rikako Imaizumi, Rikuo Ono, Yuki Kaneoka, Eri Nakajima, Masashi Kato, Yuto Sugawara, Runa Shimizu, Tomotari Inami, Kenji Kawai, Shun Matsubara, Risa Tanaka, Makoto Suzuki, Shintaro Shimozawa, Yuta Hotchi, Ippei Osugi, Risa Katou, Sakurako Ito, Kentaro Mishima, Akihiko Kondo, Keiko Mizuno, Hiroki Takami, Takayuki Komatsu, Tomohisa Nomura, Manabu Sugita, Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
Takayuki Komatsu, Department of Sports Medicine, Faculty of Medicine, Juntendo University, Bunkyo 113-8421, Tokyo, Japan
Author contributions: Usuda D wrote the manuscript; Furukawa D, Imaizumi R, Ono R, Kaneoka Y, Kato M, Sugawara Y, Shimizu R, Inami T, Kawai K, Matsubara S, Tanaka R, Suzuki M, Shimozawa S, Hotchi Y, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Nomura T, and Sugita M proofread and revised the manuscript. All authors approved the final version to be published.
Supported by the Japan Society for the Promotion of Science KAKENHI Grant, No. JP24K15491.
Informed consent statement: Written informed consent was obtained from surety of the patient for publication of this case report and any accompanying images. Both written and verbally informed consent were obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daisuke Usuda, MD, PhD, Associate Professor, Department of Emer
Received: July 1, 2025
Revised: September 4, 2025
Accepted: November 21, 2025
Published online: December 6, 2025
Processing time: 159 Days and 3.7 Hours
Revised: September 4, 2025
Accepted: November 21, 2025
Published online: December 6, 2025
Processing time: 159 Days and 3.7 Hours
Core Tip
Core Tip: Acyclovir (ACV)-resistant herpes simplex virus strains have emerged and gradually increased in number. We report the first case of ACV-resistant herpes encephalitis (ARHE) recurring in an immunocompromised adult patient without neurosurgical interventions. Clinicians should recognize this condition because treatment for ARHE is limited, and it often develops into severe herpes disease that is refractory to antiviral drug therapy. In addition, ARHE recurred in the patient following remission; therefore, it is necessary to discuss the length of the treatment period. There is no established standard treatment for recurrence cases; therefore, accumulation of evidence is needed.