Herpes Simplex Virus Infection as a Cause of Benign Recurrent Lymphocytic Meningitis

Abstract

Herpes simplex virus, predominantly HSV type 2, was the major agent causing benign recurrent lymphocytic meningitis that met our specified diagnostic criteria.

Increased Detection Rate in Diagnosis of Herpes Simplex Virus Type 2 Meningitis by Real-Time PCR Using Cerebrospinal Fluid Samples

“…The etiological diagnosis of HSV-2 meningitis is of particular importance as this condition carries a considerable risk of future neurological morbidity. HSV-2 proved to be the major cause of benign recurrent lymphocytic meningitis (30). A retrospective study (3) showed that during the year following the acute phase of HSV-2 meningitis, more than 30% of 40 patients suffered from recurrent neurological symptoms (one or several episodes of recurrent meningitis or myelitis or distinct attacks of severe headache).…”

“…After the primary infection, the virus remains latent in the nervous ganglia, where it can reactivate. HSV-2 meningitis carries a considerable risk of future neurological morbidity and is the major cause of recurrent aseptic meningitis (3,30).…”

Recurrent Herpes Simplex Type 2 Virus (Mollaret) Meningitis

“…2,7,8 After the primary infection, Herpes simplex type 2 virus becomes dormant, most commonly within the sensory neurons of the sacral dorsal root ganglia. It is believed that the retrograde seeding of the CSF by the Herpes simplex type 2 virus results in meningitis.…”

Clinical Validation of a New Triplex Real-Time Polymerase Chain Reaction Assay for the Detection and Discrimination of Herpes simplex Virus Types 1 and 2

“…It could thus be shown that severe encephalitis is mainly caused by HSV-1, whereas HSV-2 is predominantly diagnosed in patients with self-limiting recurrent aseptic meningitis. 9,18,19 HSV virus load in CSF could be correlated with morbidity and mortality in some studies. 20,21 Domingues and colleagues reported that patients with a high HSV copy number (Ͼ10 5 /ml) had a poorer prognosis than those with lower copy numbers, 5,20 whereas others did not see such a correlation.…”