Pediatric HSVE: Where Clinical Progress Meets Radiological Surprise (P7-6.015)

Literature on radiological worsening following treatment and clinical resolution in pediatric Herpes Simplex Virus Encephalitis (HSVE) is non-existent. While radiological decline following clinical relapse in HSVE patients during treatment has been reported and is unsurprising, radiological decline despite clinical resolution is a rarely reported phenomenon in adults and has never been reported in children. This highlights a disconnect between clinical status and imaging outcomes and implies a secondary inflammatory disease process beyond direct infection in HSVE.