Peer-reviewedCC BY-NC-NDInternal Medicine
Aspiration Pneumonia with Herpes Simplex Encephalitis in an Elderly Japanese Patient
Abstract
A 94-year-old woman residing in a nursing home was admitted with aspiration pneumonia. A sputum culture yielded Klebsiella pneumoniae. Despite appropriate management, the patient's mental status deteriorated. Brain magnetic resonance imaging demonstrated high signal intensity in the right insular cortex on diffusion-weighted images, raising the suspicion of limbic encephalitis. A lumbar puncture revealed clear cerebrospinal fluid (CSF) with normal cell counts and protein levels. On hospital day 5, HSV-1 DNA was detected in the CSF, confirming herpes simplex encephalitis (HSE), and acyclovir was initiated. In elderly patients with unexplained altered consciousness, clinicians should not exclude HSE based on normal CSF findings.
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BibTeX
@article{harada2026aspiration,
title = {{Aspiration Pneumonia with Herpes Simplex Encephalitis in an Elderly Japanese Patient}},
author = {Ayaka Harada and Yuichiro Iwamoto and Yoshiro Fushimi and Akiko Saito and Ryota Satake and Junpei Sanada and Tomohiko Kimura and Masashi Shimoda and Shuhei Nakanishi and Masahito Mihara and Hideaki Kaneto},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.6507-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6507-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Aspiration Pneumonia with Herpes Simplex Encephalitis in an Elderly Japanese Patient
AU - Ayaka Harada
AU - Yuichiro Iwamoto
AU - Yoshiro Fushimi
AU - Akiko Saito
AU - Ryota Satake
AU - Junpei Sanada
AU - Tomohiko Kimura
AU - Masashi Shimoda
AU - Shuhei Nakanishi
AU - Masahito Mihara
AU - Hideaki Kaneto
PY - 2026
DA - 2026/08/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.6507-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/16/65_6507-25/_article
AB - A 94-year-old woman residing in a nursing home was admitted with aspiration pneumonia. A sputum culture yielded Klebsiella pneumoniae. Despite appropriate management, the patient's mental status deteriorated. Brain magnetic resonance imaging demonstrated high signal intensity in the right insular cortex on diffusion-weighted images, raising the suspicion of limbic encephalitis. A lumbar puncture revealed clear cerebrospinal fluid (CSF) with normal cell counts and protein levels. On hospital day 5, HSV-1 DNA was detected in the CSF, confirming herpes simplex encephalitis (HSE), and acyclovir was initiated. In elderly patients with unexplained altered consciousness, clinicians should not exclude HSE based on normal CSF findings.
SN - 1349-7235
SN - 0918-2918
ER -