Herpes simplex encephalitis - Is anticoagulation safe?

Background: Herpes simplex encephalitis (HSE) still carries a high morbidity and mortality. Review Summary: The authors report a 27-year-old patient who presented with an HSE manifested by a high temperature, seizures, and headaches. His hospitalization course was complicated by a pulmonary embolism. After anticoagulation was started, the patient developed a right temporal hematoma at the same region of the abnormal signal on magnetic resonance imaging. The patient underwent a craniotomy and evacuation of the hematoma with an uneventful postoperative outcome. Conclusion: The safety of anticoagulation in HSE has not been raised in the literature previously, and it needs further study.