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Mollaret's Meningitis: A Rare Entity.

Abhinav Sehgal1, Esana Pokhrel2, Walter R Castro2

  • 1Internal Medicine, Georgetown University School of Medicine, Washington, DC, USA.

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|June 30, 2021
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Summary
This summary is machine-generated.

Mollaret's meningitis, a recurrent aseptic meningitis, has a benign prognosis without antiviral treatment. Prompt lumbar puncture aids diagnosis, and empiric antiviral therapy for herpes simplex virus encephalitis can be deferred in noninfectious cases.

Keywords:
aseptic meningitisbenign aseptic meningitisdiagnosismollaret's meningitisprognosisrecurrenttreatment

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Mollaret's meningitis is a recurrent form of aseptic meningitis.
  • Diagnosis can be challenging due to overlapping symptoms with infectious meningitis.

Observation:

  • An 83-year-old male presented with symptoms consistent with aseptic meningitis.
  • Cerebrospinal fluid analysis revealed lymphocytic pleocytosis.
  • A history of prior aseptic meningitis and a symptom-free interval suggested Mollaret's meningitis.

Findings:

  • Empiric antiviral therapy for herpes simplex virus (HSV) encephalitis was deferred.
  • Polymerase chain reaction tests for HSV-1 and HSV-2 were negative.
  • The patient showed clinical improvement within four days without antiviral treatment.

Implications:

  • Prompt lumbar puncture is crucial for diagnosing suspected Mollaret's meningitis.
  • The diagnosis of Mollaret's meningitis should be reserved for noninfectious cases.
  • Complete recovery is expected in Mollaret's meningitis, allowing deferral of empiric antiviral therapy.