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.