Controlled trials of amphotericin B lipid complex.

because it occurred in the midst of the usual seasonal increase in the number of cases of enteroviral meningitis together with cases of herpes simplex virus 1 (HSV-1) encephalitis, which occurs sporadically throughout the year. HSV-1 encephalitis may be differentiated from WNE by the presence of focal abnormalities on the electroencephalogram and/or on CT/MRI scans. Most cases of enteroviral meningitis are not accompanied by encephalitis, but enteroviral infections of the CNS are frequently accompanied by nonexudative pharyngitis, loose stools, or a maculopapular rash. Neither of these viral infections that infect the CNS is accompanied by lymphocytopenia. Although our series is limited, we believe that profound and prolonged lymphocytopenia in patients with encephalitis is an important diagnostic clue of WNE. In patients with encephalitis, aseptic meningitis, and profound lymphocytopenia, clinicians should rule out enteroviral meningoencephalitis and HSV-1 encephalitis and should order specific WNE serological testing.