Audit of HSV encephalitis management within a DGH

<h3></h3> Herpes simplex virus (HSV) encephalitis is a rare diagnosis which carries a high mortality and morbidity if not promptly treated. Patients with HSV encephalitis typically present with a variable combination of fever, confusion, behavioural changes, and seizure. The presenting features of HSV encephalitis are non-specific and have a wide differential diagnosis which can lead to a delay in appropriately investigating and treating a suspected case of HSV encephalitis. Current management of HSV encephalitis in the UK follows the 2012 Solomon and colleagues’ guidelines. However, in practice some of the recommendations can be difficult to follow due to variations in local provisions e.g. timely PCR. We looked to compare the standard of HSV management within a district general hospital to that of the current HSV guidelines. An audit was performed within NHS Fife on the management of suspected HSV encephalitis cases over a 1-year period from June of 2021 to June of 2022. Audit criteria was adapted from the 2012 Solomon and colleagues’ guidelines ‘management of suspected viral encephalitis in adults’ and applied to patients admitted to the medical admissions unit and/or critical care areas. Audit items included timings to perform CSF investigations, additional investigations performed, and timings of Acyclovir initiation and duration, as well as other categories. The results from the audit were then compared against the current recommended standards.