Recurrent herpes simplex virus type 2 meningitis: a case report of Mollaret's meningitis.
It is well known that herpes simplex virus (HSV) type 2 produces acute meningitis, while HSV type 2 rarely causes recurrent meningitis (Mollaret's meningitis). We report the history of a 40-year-old patient with recurrent HSV type 2 meningitis (Mollaret's meningitis). The patient had seven episodes of meningeal symptoms within a 7-year period. In the seventh episode, HSV type 2 DNA was confirmed by nested polymerase chain reaction (PCR) with the cerebrospinal fluid (CSF). A real-time quantitative PCR study of the first CSF sample detected 2,000 copies of the HSV genome, which rapidly disappeared following treatment with acyclovir. The present case may be the first case of HSV type 2 Mollaret's meningitis to be documented in Japan. In our case, HSV serum antibody titers were at low levels during the whole course of the disease. The possible pathophysiology of this case is discussed.
Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu 870-8555, Japan.
Yuki
Y
Kojima
Hideyuki
H
Hashiguchi
Tomoko
T
Hashimoto
Sadatoshi
S
Tsuji
Hiroshi
H
Shoji
Yukumasa
Y
Kazuyama
D000212:Acyclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D006558:Herpes Genitalis / Q000821:virology; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification* / Q000472:pathogenicity*; D006801:Humans; D007564:Japan; D008297:Male; D008587:Meningitis, Viral / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology*; D016133:Polymerase Chain Reaction; D012008:Recurrence; D013997:Time Factors; D000077483:Valacyclovir; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir