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Case report
Mania presenting as a VZV encephalitis in the context of HIV
  1. Oliver George1,
  2. Jessica Daniel2,
  3. Sophie Forsyth2 and
  4. David Enright3
  1. 1Postgraduate Department, Kings College Hospital, Denmark Hill, London, Greater London, UK
  2. 2Department of Sexual Health, Great Western Hospitals NHS Foundation Trust, Swindon, UK
  3. 3Department of Psychiatry, Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, Bath and North East Somerset, UK
  1. Correspondence to Dr Oliver George; og13479{at}


Acute encephalitis can be life-threatening, especially in the immunocompromised population. Viruses are the main infectious agents, with varicella zoster virus (VZV) a common cause. Neuropsychiatric symptoms are well documented, but it is rare for mania to be the only symptom on presentation. Here, we report a case of hypomania in a 31-year-old white British heterosexual man who following investigation was found to be HIV positive and subsequently diagnosed with VZV encephalitis. To date, we are unaware of any similarly reported cases. It is important to raise awareness of atypical HIV presentations to improve clinical outcomes for patients.

  • psychiatry

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  • Contributors All authors have made original contributions to this article, helping with the writing, formatting and editing in its entirety. They have all approved that this version should be put forward for publication. Specific contributions are as follows: OG lead author; and JD, SF and DE co-authors and editors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.