title: Reactivation of herpes simplex type 1 in pneumococcal meningitis.
abstract: BACKGROUND
  Acute bacterial meningitis (ABM) and herpes simplex type 1 (HSV-1) encephalitis are two rare but serious infections affecting the central nervous system (CNS). Concurrent bacterial and viral CNS infection has occasionally been reported.
  
  
  OBJECTIVE
  To illustrate the possibility of intrathecal infection with both Streptococcus pneumonia and HSV-1 by presenting a case and to examine whether herpesvirus reactivation is common in ABM.
  
  
  METHODS
  We report a case diagnosed with HSV-1 reactivation in the cerebrospinal fluid (CSF) during treatment for pneumococcal ABM. A retrospective analysis of CSF samples from 21 patients with ABM was performed, with analysis of DNA from HSV-1 and four other neurotropic herpesviruses.
  
  
  RESULTS
  All 21CSF samples were negative for HSV-1, HSV-2, varicella zoster-virus, Epstein-Barr virus and human herpesvirus 6 DNA by PCR.
  
  
  CONCLUSIONS
  Although herpesvirus infection does not seem to be a common phenomenon in ABM we suggest that HSV-1 reactivation could be kept in mind if patients with ABM show symptoms or signs compatible with encephalitis.
authors: Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden. Electronic address: anna-carin.ericsdotter@rjl.se.
authors: Anna-Carin
authors: AC
authors: Ericsdotter
authors: Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.
authors: Magnus
authors: M
authors: Brink
authors: Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.
authors: Marie
authors: M
authors: Studahl
authors: Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
authors: Malin
authors: M
authors: Bengnér
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002555:Cerebrospinal Fluid / Q000821:virology; D060085:Coinfection / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D005260:Female; D018259:Herpesvirus 1, Human / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications*; D008875:Middle Aged; D012189:Retrospective Studies; D014775:Virus Activation; D055815:Young Adult
keywords: Bacterial meningitis; CSF; HSV-1 encephalitis