A man in his twenties was transferred to our hospital in shock with splenic injury, thoracic trauma, and pelvic/limb fractures. We performed splenectomy on the same day, followed by open reduction and internal fixation on hospital day 6. His clinical course was good, but on day 14, he developed disturbance of consciousness with high fever, and herpes simplex virus was detected in blisters on his fingers and ear. In addition, brain MRI demonstrated abnormal high-intensity signals. We diagnosed him with herpes simplex infection and acute disseminated encephalomyelitis with disturbance of consciousness. We administered acyclovir, which immediately improved his symptoms. When a patient develops unexplained high fever after splenectomy or treatment for severe trauma, traumatologists need to keep in mind not only bacterial infections but also viral infections such as herpes simplex.
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