title: HSV-2 meningoencephalitis in an immunocompetent young man: what is the pathogenesis and what is the treatment?
abstract: Herpes simplex encephalitis is rarely caused by herpes simplex virus type 2 (HSV-2) after the neonatal period. The pathogenesis of HSV-2 encephalitis is not known and its treatment has not been discussed. We report a case of mild meningoencephalitis secondary to HSV-2 primary infection after sexual risk behaviour in a healthy young man. The diagnosis was established upon clinical, biological and electroencephalographic criteria. Aciclovir treatment led to rapid clinical improvement. This case highlights HSV-2 as a rare cause of meningoencephalitis, and questions the management of this rare manifestation of HSV-2 infection.
authors.affiliation: Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France; Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France. Electronic address: mariepaulefernandez@yahoo.fr.
authors.forename: Mp
authors.initials: M
authors.lastname: Fernandez-Gerlinger
authors.affiliation: Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France.
authors.forename: S
authors.initials: S
authors.lastname: Greffe
authors.affiliation: Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France.
authors.forename: A
authors.initials: A
authors.lastname: Meffre
authors.affiliation: Service d'accueil des urgences, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France.
authors.forename: J
authors.initials: J
authors.lastname: Grenet
authors.affiliation: Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France; Service de réanimation médico-chirurgicale, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France.
authors.forename: S
authors.initials: S
authors.lastname: Au
authors.affiliation: Service de Virologie, Université Paris Descartes & Hôpitaux Universitaires Paris Centre, AP-HP, 75014 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Bojanova
authors.affiliation: Service de médecine interne, Hôpital Ambroise Paré, AP-HP, 92104 Boulogne-Billancourt, France; Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
authors.forename: E
authors.initials: E
authors.lastname: Rouveix
authors.affiliation: Service de Virologie, Université Paris Descartes & Hôpitaux Universitaires Paris Centre, AP-HP, 75014 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Rozenberg
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D006558:Herpes Genitalis / Q000150:complications* / Q000821:virology; D006561:Herpes Simplex / Q000175:diagnosis; D018258:Herpesvirus 2, Human / Q000187:drug effects / Q000235:genetics / Q000276:immunology; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000821:virology*; D016133:Polymerase Chain Reaction; D011859:Radiography
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D000212:Acyclovir
keywords: HSV-2; Meningoencephalitis; Primary infection; Sexually transmitted disease