Acute viral encephalitis (AVE) is suspected in patients suffering from a febrile disease with headache and altered sensorium. Herpes simplex virus (HSV) is one of the major etiological agents for AVE. Here, we present an atypical case of HSV encephalitis with intracerebral bleed in a 23-year-old male. The patient presented with fever, headache, seizure episodes and altered sensorium. Computed tomography scan of head suggested cerebral edema. Cerebrospinal fluid (CSF) routine microscopy showed increased cell count with lymphocytic pleocytosis, increased protein and normal sugar levels. CSF polymerase chain reaction was suggestive of HSV encephalitis. The patient showed improvement with intravenous acyclovir and cerebral decongestants, but after 15 days, he complained of headache. Repeat imaging showed bleed at the site of lesion. Diagnosis of AVE with intracerebral bleed was made.J Neurol Res. 2015;5(4-5):261-263doi: http://dx.doi.org/10.14740/jnr349w
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