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HSV meningitis is meningitis associated with a herpes simplex virus (HSV) infection.[1]
HSV is a common cause of viral meningitis, with HSV-2 the second most common cause of meningitis in adults.[2] HSV-1 can also cause meningitis.[3] HSV meningitis can occur either with the initial symptoms of a herpes infection or later upon re-activation of a prior infection.[4]
Clinical presentation
editCommon symptoms include nausea, vomiting, neck-stiffness, photophobia, and severe frontal headaches.[2] Patients with meningitis secondary to the HSV-2 virus may also present with genital lesions, although most cases of HSV-2 meningitis occur without symptoms of genital herpes.[5][6] Around one fifth of people infected with HSV-2 have symptoms of meningitis with their initial infection, more commonly men than women.[7]
Diagnosis
editHSV meningitis can be diagnosed through a spinal tap, and PCR analysis of the cerberospinal fluid for HSV DNA. Not everyone with an HSV infection and meningitis tests positive for HSV DNA in the cerebrospinal fluid.[8]
Treatment
editHSV meningitis often spontaneously recovers.[9] Treatment is usually supportive with the antivirals acyclovir and valacyclovir sometimes given.[1]
Incidence
editHerpes is a common cause of viral meningitis, with around one in twenty viral meningitis cases caused by a herpes simplex virus.[10] HSV-2 is the most common cause of meningitis in adults[1]. Herpesviral meningitis primarily affects people aged 35-40, the elderly, and women.[11]
Recurrent Herpesviral meningitis
editHerpesviral meningitis can sometimes be recurring, with HSV-2 causing most cases of recurrent benign lymphatic meningitis.[4] Deficient T-cell immunity can make someone more prone to recurrent meningitis.[4]
Mollaret's meningitis, a specific type of recurrent meningitis first described in 1944, has since been found to be most commonly caused by HSV-2.[12][1]
Mollaret's Meningitis
editHSV-2 is the most common cause of Mollaret's meningitis, a type of recurrent viral meningitis.[1] This condition was first described in 1944 by French neurologist Pierre Mollaret. Recurrences usually last a few days or a few weeks, and resolve without treatment. They may recur weekly or monthly for approximately 5 years following primary infection.[13]
See also
editReferences
edit- ^ a b c d e Tyler KL (2004). "Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's". Herpes. 11. Suppl 2: 57A–64A. PMID 15319091.
- ^ a b Landry, Marie L.; Greenwold, Jennifer; Vikram, Holenarasipur R. (2009-07). "Herpes Simplex Type-2 Meningitis: Presentation and Lack of Standardized Therapy". The American Journal of Medicine. 122 (7): 688–691. doi:10.1016/j.amjmed.2009.02.017. ISSN 0002-9343.
{{cite journal}}: Check date values in:|date=(help) Cite error: The named reference ":3" was defined multiple times with different content (see the help page). - ^ Gundamraj, Vaishnavi; Hasbun, Rodrigo (June 2023). "Viral meningitis and encephalitis: an update". Current Opinion in Infectious Diseases. 36 (3): 177–185. doi:10.1097/QCO.0000000000000922. ISSN 0951-7375.
- ^ a b c Zhu, Shuyong; Viejo-Borbolla, Abel (2021-12-31). "Pathogenesis and virulence of herpes simplex virus". Virulence. 12 (1): 2670–2702. doi:10.1080/21505594.2021.1982373. ISSN 2150-5594. PMC 8923070. PMID 34676800.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Corey, Lawrence (June 1, 1983). "Genital Herpes Simplex Virus Infections: Clinical Manifestations, Course, and Complications". Annals of Internal Medicine. 98 (6): 958–972. doi:10.7326/0003-4819-98-6-958. ISSN 0003-4819. PMID 6344712.
- ^ Landry, Marie L.; Greenwold, Jennifer; Vikram, Holenarasipur R. (July 2009). "Herpes Simplex Type-2 Meningitis: Presentation and Lack of Standardized Therapy". The American Journal of Medicine. 122 (7): 688–691. doi:10.1016/j.amjmed.2009.02.017.
- ^ Rosenberg, Jon; Galen, Benjamin T. (July 2017). "Recurrent Meningitis". Current Pain and Headache Reports. 21 (7). doi:10.1007/s11916-017-0635-7. ISSN 1531-3433.
- ^ Shalabi, M.; Whitley, R. J. (2006-11-01). "Recurrent Benign Lymphocytic Meningitis". Clinical Infectious Diseases. 43 (9): 1194–1197. doi:10.1086/508281. ISSN 1058-4838.
- ^ Cite error: The named reference
:2was invoked but never defined (see the help page). - ^ Student Research Committee, Alborz University of Medical Sciences Faculty of Medicine, Karaj, Iran; Rohani, Hoorieh; Arjmand, Reza; Department of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Alborz, Karaj, Iran; Mozhgani, Sayed-Hamidreza; Department of Microbiology, Alborz University of Medical Sciences Faculty of Medicine, Karaj, Iran;Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Shafiee, Arman; Student Research Committee, Alborz University of Medical Sciences Faculty of Medicine, Karaj, Iran; Amini, Mohammad Javad; Student Research Committee, Alborz University of Medical Sciences Faculty of Medicine, Karaj, Iran; Forghani-Ramandi, Mohammad-Moien; Student Research Committee, Alborz University of Medical Sciences Faculty of Medicine, Karaj, Iran (2023-08-08). "The Worldwide Prevalence of Herpes Simplex Virus Encephalitis and Meningitis: A Systematic Review and Meta-Analysis". Turkish Archives of Pediatrics. doi:10.5152/TurkArchPediatr.2023.23007. PMC 10724770. PMID 37553966.
{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: multiple names: authors list (link) - ^ Rozenberg, Flore (October 2020). "Herpes simplex virus and central nervous system infections: encephalitis, meningitis, myelitis". Virologie. 24 (5): 283–294. doi:10.1684/vir.2020.0862. ISSN 1267-8694.
- ^ Sendi, P. (2006-06-06). "Mollaret's meningitis". Canadian Medical Association Journal. 174 (12): 1710–1710. doi:10.1503/cmaj.051688. ISSN 0820-3946. PMC 1471823. PMID 16754896.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Sendi P, Graber P (2006). "Mollaret's meningitis". CMAJ. 174 (12): 1710. doi:10.1503/cmaj.051688. PMC 1471823. PMID 16754896.