Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Herpes simplex virus type 2-associated recurrent aseptic meningitis (Mollaret's meningitis) with a recurrence after 11-year interval: a case report

Yoshitsugu Nakamura, M.D.1), Hideto Nakajima, M.D.1), Yosuke Kano, M.D.1), Kiichi Unoda, M.D.1), Shimon Ishida, M.D.1) and Fumiharu Kimura, M.D.1)

1)Division of Neurology, Department of Internal Medicine I, Osaka Medical College

A 55-year-old woman was diagnosed with aseptic meningitis at the age of 43 and 44. She developed sudden fever and headache, and she showed nuchal rigidity. Cerebrospinal fluid examination revealed pleocytosis (cell count 208/mm3) and was positive for herpes simplex virus type 2 (HSV-2) DNA by PCR. Acyclovir was started on the first day of admission, and she was complete recovery. Preserved cerebrospinal fluid specimen from aseptic meningitis at the age of 44 was also positive for HSV-2 DNA by PCR. She was diagnosed with HSV-2 associated recurrent aseptic meningitis (Mollaret's meningitis) with a recurrence after 11-year interval. She repeatedly relapsed genital herpes after 44 years old and she was treated with valacyclovir whenever genital herpes relapses. But she showed no genital herpes at the onset of meningitis. Because HSV-2 is one of the most significant causes of recurrent meningitis, we would like to stress that HSV-2 infection and antiviral therapy should always be kept in mind for a recurrent meningitis case.
Full Text of this Article in Japanese PDF (472K)

(CLINICA NEUROL, 56: 785|787, 2016)
key words: recurrent meningitis, Mollaret's meningitis, herpes simplex virus type 2, genital herpes, remission period

(Received: 28-Aug-16)