Recurrent Lymphocytic Meningitis

Kupila, Laura; Vainionpää, Raija; Vuorinen, Tytti; Marttila, Reijo J.; Kotilainen, Pirkko

doi:10.1001/archneur.61.10.1553

Cited by 39 publications

(16 citation statements)

References 21 publications

(13 reference statements)

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“…The HHV (HSV‐1, HSV‐2, VZV, EBV, and CMV) can cause a variety of acute infections of the CNS from either a primary infection or reactivation of latent virus, and are often associated with encephalitis and meningitis [Kupila et al, ; Frantzidou et al, ]. The genome of herpesviruses in the present study was detected in more than half of the PCR positive patients.…”

Section: Discussionsupporting

confidence: 47%

Detection ofHerpesvirus,Enterovirus, andArbovirusinfection in patients with suspected central nervous system viral infection in the Western Brazilian Amazon

et al. 2014

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Acute infections of the central nervous system (CNS) can be caused by various pathogens. In this study, the presence of herpesviruses (HHV), enteroviruses (EVs), and arboviruses were investigated in CSF samples from 165 patients with suspected CNS viral infection through polymerase chain reaction (PCR) and reverse transcriptase PCR. The genomes of one or more viral agents were detected in 29.7% (49/165) of the CSF samples. EVs were predominant (16/49; 32.6%) followed by Epstein-Barr virus (EBV) (22.4%), Varicella-Zoster virus (VZV) (20.4%), Cytomegalovirus (CMV) (18.4%), herpes simplex virus (HSV-1) (4.1%), (HSV-2) (4.1%), and the arboviruses (14.3%). Four of the arboviruses were of dengue virus (DENV) and three of oropouche virus (OROV). The detection of different viruses in the CNS of patients with meningitis or encephalitis highlight the importance of maintaining an active laboratory monitoring diagnostics with rapid methodology of high sensitivity in areas of viral hyperendemicity that may assist in clinical decisions and in the choice of antiviral therapy.

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Section: Discussionsupporting

confidence: 47%

Detection ofHerpesvirus,Enterovirus, andArbovirusinfection in patients with suspected central nervous system viral infection in the Western Brazilian Amazon

et al. 2014

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“…The disease is characterized by recurrent periods of neck stiffness, headaches and fever, and the presence of large cells in cerebrospinal fluid (CSF). Since the development of the PCR technique, the causative agent of recurrent meningitis (RM) is generally considered to be herpes simplex virus type 2 (HSV-2) (22,36,43), which is readily detectable in CSF. The first episode of HSV-2 meningitis usually develops within 2 weeks following symptomatic or asymptomatic primary genital HSV-2 infection (8,37).…”

mentioning

confidence: 99%

Increased Cell-Mediated Immune Responses in Patients with Recurrent Herpes Simplex Virus Type 2 Meningitis

Franzén‐Röhl

Schepis

Lagrelius

et al. 2011

Clin. Vaccine Immunol.

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The clinical picture of herpes simplex virus type 2 (HSV-2) infection includes genital blisters and less frequently meningitis, and some individuals suffer from recurrent episodes of these manifestations. We hypothesized that adaptive and/or innate immune functional deficiencies may be a major contributing factor in susceptibility to recurrent HSV-2 meningitis. Ten patients with recurrent HSV-2 meningitis were studied during clinical remission. For comparison, 10 patients with recurrent genital HSV infections as well as 21 HSV-seropositive and 19 HSV-seronegative healthy blood donors were included. HSV-specific T cell blasting and cytokine secretion were evaluated in whole blood cultures. HSV-2-induced NK cell gamma interferon production, dendritic cell Toll-like receptor (TLR) expression, and TLR agonist-induced alpha interferon secretion were analyzed. Patients with recurrent HSV-2 meningitis had elevated T cell blasting and Th1 and Th2 cytokine production in response to HSV antigens compared to those of patients with recurrent genital infections. A somewhat increased NK cell response, increased dendritic cell expression of TLR3 and -9, and increased TLR-induced alpha interferon responses were also noted. Contrary to our expectation, recurrent HSV-2 meningitis patients have increased HSV-specific adaptive and innate immune responses, raising the possibility of immune-mediated pathology in the development of recurrent HSV2 meningitis.

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“…Besides the CSF pleocytosis with characteristic mononuclear endothelial cells nucleic acid testing revealed a positive result for HSV-2. HSV-2 is known to induce recurrent meningitis as it was the case in our patient [5,6] . Cases without fever were also reported earlier by Galdi et al [7] .…”

Section: Discussionmentioning

confidence: 60%

Toll-Like Receptor 3 Immune Deficiency May Be Causative for HSV-2-Associated Mollaret Meningitis

Willmann¹,

Ahmad-Nejad²,

Neumaier³

et al. 2010

Eur Neurol

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Recurrent Lymphocytic Meningitis

Cited by 39 publications

References 21 publications

Detection ofHerpesvirus,Enterovirus, andArbovirusinfection in patients with suspected central nervous system viral infection in the Western Brazilian Amazon

Detection ofHerpesvirus,Enterovirus, andArbovirusinfection in patients with suspected central nervous system viral infection in the Western Brazilian Amazon

Increased Cell-Mediated Immune Responses in Patients with Recurrent Herpes Simplex Virus Type 2 Meningitis

Toll-Like Receptor 3 Immune Deficiency May Be Causative for HSV-2-Associated Mollaret Meningitis

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