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[Viral or bacterial meningitis. Differential diagnostic problems].

P Aukrust, H Haugtomt

    Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
    |February 10, 1989
    PubMed
    Summary
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    Herpes simplex virus type 2 can cause meningitis, even in healthy young adults. Standard cerebrospinal fluid tests may be insufficient for diagnosis, highlighting the need for careful evaluation.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Virology

    Background:

    • Meningitis diagnosis traditionally relies on cerebrospinal fluid (CSF) analysis.
    • Distinguishing between bacterial and viral meningitis is crucial for appropriate treatment.

    Observation:

    • A 19-year-old male presented with meningitis symptoms.
    • Cerebrospinal fluid culture identified herpes simplex virus type 2 (HSV-2) as the causative agent.
    • The patient experienced a benign clinical course with full recovery.

    Findings:

    • CSF analysis revealed prolonged pleocytosis and low glucose levels.
    • Traditional CSF parameters were found to be inadequate for definitive diagnosis in this case.
    • CSF differential cell count, particularly when repeated, showed the most diagnostic value.

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    Implications:

    • This case underscores the limitations of standard CSF parameters in diagnosing viral meningitis.
    • Herpes simplex virus type 2 meningitis can present with atypical CSF findings.
    • Further investigation into diagnostic markers, such as CSF lactate, may be beneficial.