In conclusion
HSE complicated by vasculitis should be considered, especially in patients who do not show clinical improvement or experience worsening symptoms in the weeks following the initiation of treatment. This complication is usually associated with HSV -2 (8), but HSV-1 is also a rare but possible cause. Considering empirical treatment with steroids is of paramount importance since vascular imaging may not always be available or may not detect this complication, ultimately leading to better patient outcomes.