Herpes simplex-2 meningitis presenting with headache in pregnancy

Area of Science:

• Virology
• Neurology
• Obstetrics

Background:

• Herpes simplex virus type 2 (HSV-2) typically causes genital infections but can lead to central nervous system disease, including meningitis.
• Meningitis during pregnancy, particularly from HSV-2, presents diagnostic and management challenges due to its rarity and potential impact on maternal and fetal health.

Purpose of the Study:

• To report a case of a pregnant woman diagnosed with HSV-2 meningitis.
• To highlight the importance of multidisciplinary collaboration in managing such cases and planning for delivery and postnatal care.

Main Methods:

• A case study of a nulliparous woman at 22 weeks' gestation presenting with headache and suspected meningitis.
• Diagnostic workup included head CT, MRA, and cerebrospinal fluid (CSF) culture.
• Treatment involved intravenous acyclovir and multidisciplinary team consultations.

Main Results:

• Cerebrospinal fluid culture confirmed HSV-2 meningitis.
• The patient responded well to intravenous acyclovir, with resolution of headache.
• The case underscores the need for a coordinated approach involving various medical specialists.

Conclusions:

• HSV-2 meningitis during pregnancy requires prompt recognition and management.
• Multidisciplinary team involvement is essential for optimizing outcomes and planning birth and neonatal care.
• Further literature on HSV-2 meningitis in pregnancy is needed to guide obstetric management.