{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:19:17Z","timestamp":1773983957459,"version":"3.50.1"},"reference-count":10,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,7,31]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2019-230512","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T03:20:14Z","timestamp":1599535214000},"page":"e230512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Mania presenting as a VZV encephalitis in the context of HIV"],"prefix":"10.1136","volume":"13","author":[{"given":"Oliver","family":"George","sequence":"first","affiliation":[{"name":"Postgraduate Department, Kings College Hospital, Denmark Hill, London, Greater London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Sexual Health, Great Western Hospitals NHS Foundation Trust, Swindon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Forsyth","sequence":"additional","affiliation":[{"name":"Department of Sexual Health, Great Western Hospitals NHS Foundation Trust, Swindon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Enright","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, Bath and North East Somerset, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"2025082800164112000_13.9.e230512.1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.78.924.575"},{"key":"2025082800164112000_13.9.e230512.2","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(14)60755-8","article-title":"Disseminated varicella zoster virus encephalitis","volume":"384","author":"Chai","year":"2014","journal-title":"Lancet"},{"key":"2025082800164112000_13.9.e230512.3","doi-asserted-by":"crossref","first-page":"bcr0320125970","DOI":"10.1136\/bcr.03.2012.5970","article-title":"Acute encephalitis as initial presentation of primary HIV infection","volume":"2012","author":"Nzwalo","year":"2012","journal-title":"BMJ Case Rep"},{"key":"2025082800164112000_13.9.e230512.4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1177\/070674379203700412","article-title":"Encephalitis associated with herpes zoster: a case report and review","volume":"37","author":"McKenna","year":"1992","journal-title":"Can J Psychiatry"},{"key":"2025082800164112000_13.9.e230512.5","doi-asserted-by":"crossref","first-page":"2775","DOI":"10.2147\/NDT.S82380","article-title":"Autoimmune encephalitis in psychiatric institutions: current perspectives","volume":"12","author":"Bost","year":"2016","journal-title":"Neuropsychiatr Dis Treat"},{"key":"2025082800164112000_13.9.e230512.6","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1590\/S0036-46652015000600007","article-title":"Meningoencephalitis due to varicella zoster virus in AIDS patients. Report of eleven cases and review of the literature","volume":"57","author":"Corti","year":"2015","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"2025082800164112000_13.9.e230512.7","unstructured":"British HIV Association . British association for sexual health and HIV (BASHH), the British HIV association (BHIVA), and the British infection Society (bis) guidelines for HIV testing, 2008. Available: www.bhiva.org\/HIVTesting2008.aspx [Accessed 3 Apr 2019]."},{"key":"2025082800164112000_13.9.e230512.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2005.02.001"},{"key":"2025082800164112000_13.9.e230512.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5148"},{"key":"2025082800164112000_13.9.e230512.10","unstructured":"Kirwan PD , Chau C , Brown AE , et al . HIV in the UK - 2016 report, 2016. Available: www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/602942\/HIV_in_the_UK_report.pdf [Accessed 3 Apr 2019]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:16:50Z","timestamp":1756365410000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,7]]},"published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1136\/bcr-2019-230512"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230512","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}