Anorexia nervosa with herpes simplex encephalitis.

Introduction The incidence of infectious complications in anorexia nervosa is uncertain. It has been suggested that leucopenia in anorexia nervosa contributes to susceptibility to infection or to immunological deficiencies (Hurd, Palumbo and Gharib, 1977). However, the meaning of isolated laboratory investigations with regard to the clinical state of the patient with anorexia nervosa is considered questionable (Lucas, 1977) and in fact studies have shown a lack of association of leucopenia with increased propensity to infection in anorexia nervosa (Bowers and Eckert, 1978). On the contrary, patients with anorexia nervosa have been found to be exceptionally free from infections until very advanced stages of the illness. They rarely develop the common cold or influenza and seldom die from infective illness (Crisp, 1967; Dally, 1969). Dally reported that patients complain after regaining weight that they lose this immunity. In contrast to the supposed resistance to infections, there is evidence to suggest an increased susceptibility to tuberculosis (Dally, 1969; Crisp, Palmer and Kalucy, 1976). A recent investigation of the immune response of patients suffering from anorexa nervosa showed higher titres of antibodies in response to 3 different influenza antigens, and similar cellular immune responses to tuberculin when compared with controls (Armstrong-Esther et al., 1978). In the light of this, a case is reported of a patient with anorexia nervosa who developed herpes simplex encephalitis.