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Low-dose acyclovir for HSV-2 meningitis in a child.

S A Kohlhoff1, T A Marciano, S A Rawstron

  • 1Department of Pediatric Infectious Diseases, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 49, Brooklyn, NY 11217, USA. stephan.kohlhoff@downstate.edu

Acta Paediatrica (Oslo, Norway : 1992)
|October 1, 2004
PubMed
Summary

Genital herpes in a child caused by HSV-2 meningitis resolved with standard acyclovir. This suggests that high-dose or prolonged therapy is unnecessary for HSV-2 meningitis, even in pediatric cases.

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Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Virology

Background:

  • Genital herpes, caused by herpes simplex virus (HSV), can lead to serious complications.
  • HSV type 2 (HSV-2) meningitis is a rare but significant neurological complication.

Observation:

  • A 7-year-old girl presented with symptoms of dysuria, fever, and meningeal signs following sexual abuse.
  • Initial diagnosis suggested genital herpes, and she received acyclovir treatment for severe genitourinary symptoms.

Findings:

  • Cerebrospinal fluid (CSF) culture confirmed the presence of HSV type 2 (HSV-2).
  • The patient experienced complete resolution of all symptoms, including meningitis and genitourinary issues.
  • The treatment regimen involved standard-dose acyclovir (15 mg/kg/d for 10 days).

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Implications:

  • This case suggests that standard-dose acyclovir is effective for treating HSV-2 meningitis in children.
  • Prolonged or high-dose acyclovir therapy may not be necessary for pediatric HSV-2 meningitis, mirroring findings in adult populations.
  • Highlights the importance of considering and diagnosing HSV-2 meningitis in pediatric cases presenting with relevant symptoms, even after sexual abuse.