A case of herpes simplex encephalitis: Predisposing factors-chemotherapy or chronic alcoholism?

Opportunistic infections acquired during the chemotherapy forms the main limiting factor in the management of acute myeloid leukemia. Bacterial infections are most common, followed by fungal and rarely viral. Alcohol in high doses and long-term consumption also decreases the immunological response. Here, we present a unique case of herpes simplex encephalitis in a 50-year-old male patient who has presented with altered behavior, slurring of speech, disorientation, fever on and off, and confusion for 2 days. He was a known case of acute myeloid leukemia and treated with chemotherapy 5 years back. Moreover, he was also a chronic alcoholic for many years and stopped 1 week before the symptoms. The possible mechanism of immunodeficiency by chemotherapy and alcohol are discussed.