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Herpes simplex virus 2 meningitis: a retrospective cohort study.
Stephanie Miller1, Farrah J Mateen, Allen J Aksamit
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Journal of Neurovirology
|March 16, 2013
Summary
Herpes simplex virus type 2 (HSV-2) meningitis is a common cause of recurrent viral meningitis. This study found no serious long-term complications in patients treated with antivirals, suggesting a favorable prognosis.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Herpes simplex virus type 2 (HSV-2) is a primary cause of viral meningitis.
- It is the most common infectious cause of benign, recurrent meningitis.
Purpose of the Study:
- To retrospectively analyze patients diagnosed with HSV-2 meningitis.
- To evaluate clinical presentation, cerebrospinal fluid (CSF) findings, neuroimaging, treatment, and outcomes.
Main Methods:
- Retrospective observational cohort study at Mayo Clinic (1995-2008).
- Included patients with meningitis confirmed by HSV-2 detection via PCR in CSF.
- Analyzed medical records for symptoms, CSF analysis, neuroimaging, and treatment regimens.
Main Results:
- 28 patients with 33 episodes identified; 83% female, mean age 36.
- Common symptoms included headache, photophobia, and fever.
- CSF showed elevated protein and white blood cells with normal glucose.
- Most neuroimaging (83%) was normal.
- No patients experienced seizures, neurological disability, or death during follow-up (mean 3.4 years).
Conclusions:
- HSV-2 meningitis is characterized by specific clinical and CSF findings.
- Treatment with intravenous acyclovir and oral valacyclovir appears effective.
- Patients generally have a good prognosis with no long-term neurological sequelae.
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