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Herpes simplex virus type 2 myelitis mimicking ICU-acquired weakness as a complication of meningococcal meningitis: A

Ken Tsutsumi1, Hiroki Saito1, Yuka Kitano1

  • 1Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|November 18, 2020
PubMed

Insights

Reactivated Herpes simplex virus 2 (HSV-2) myelitis, triggered by sepsis-induced immunosuppression, can mimic intensive care unit-acquired weakness. This case highlights the critical need to rule out viral myelitis in such scenarios.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Herpes simplex virus 2 (HSV-2) is a known cause of neurological complications.
  • Sepsis can lead to immunosuppression, potentially triggering latent viral infections.
  • Myelitis, inflammation of the spinal cord, can result from various infectious agents.

Observation:

  • A patient undergoing treatment for meningococcal meningitis developed quadriparesis.
  • The patient's symptoms mimicked intensive care unit-acquired weakness.
  • Diagnostic evaluation revealed the cause to be reactivated HSV-2 myelitis.

Findings:

  • This case represents the first reported instance of HSV-2 myelitis reactivated due to sepsis-induced immunosuppression.
  • The clinical presentation of HSV-2 myelitis closely resembled ICU-acquired weakness, posing a diagnostic challenge.

Implications:

  • Early and accurate diagnosis of viral myelitis is crucial, especially in immunocompromised patients.
  • Excluding viral myelitis is essential before diagnosing conditions like ICU-acquired weakness.
  • This case underscores the importance of considering viral etiologies in neurological deficits following critical illness and immunosuppression.
Keywords:
HSV-2 myelitisICU-acquired weaknessImmunosuppressionSepsis

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