Herpetic Encephalitis Associated with Multiple Myeloma: Diagnostic Challenge| Biomed Grid

Multiple myeloma is the second most common onco-hematologic neoplasm, accounting for 1% of malignant neoplasms. It is an underdiagnosed condition, as well as herpetic encephalitis. However, it has been known that the relation of myeloma with infections is common, due to the involvement of humoral immunity. Herpetic viral encephalitis has as its main etiological agent the herpes simplex virus 1. The case was described based on a clinical reasoning about a diagnosis permeated by multiple plausible diagnostic possibilities, aiming to contribute to a better characterization of the clinical and diagnosis of two entities that have low rates of diagnostic suspicion and high rates of morbidity and mortality. During the investigation, several etiologies were proposed as responsible for the decreased level of consciousness, leading to a search for a broader range of diagnostic hypotheses, which preceded confirmation of the final diagnosis. The atypical clinical described here presented obstacles to the correct diagnostic suspicion, so that the absence of signs and symptoms characteristic of both diseases led to a search for a broader arsenal of differential diagnoses. Thus, delayed diagnosis and late treatment were factors that contributed to the patients' reserved prognosis. The association of both diseases are poorly described in the literature, so further studies on that subject are necessary