Recurrent meningitis attributable to herpes simplex virus-2 in a child

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Virology

Background:

• Recurrent meningitis can have various etiologies, posing diagnostic challenges.
• Herpes simplex virus type 2 (HSV-2) is an uncommon cause of meningitis, particularly in immunocompetent individuals without a history of genital herpes.
• Aseptic meningitis requires careful investigation to identify the causative agent.

Observation:

• A young male patient experienced recurrent episodes of meningitis.
• Symptoms included headaches, dizziness, photophobia, loss of balance, and vomiting.
• No concurrent or prior genitourinary involvement was noted.

Findings:

• The patient underwent three episodes of aseptic meningitis.
• Polymerase chain reaction (PCR) analysis of cerebrospinal fluid confirmed HSV-2 etiology in the latter two episodes.
• Treatment with acyclovir following the third episode led to a complete resolution of symptoms.

Implications:

• This case highlights HSV-2 as a potential, albeit rare, cause of recurrent aseptic meningitis in children.
• Early diagnosis and antiviral therapy (acyclovir) are crucial for managing HSV-2 meningitis.
• The successful outcome suggests that timely intervention can prevent long-term neurological sequelae.