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      Recurrent Lymphocytic Meningitis Positive for Herpes Simplex Virus Type 2

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          Abstract

          We found the prevalence of recurrent lymphocytic meningitis associated with herpes simplex virus type 2 (HSV-2) was 2.2/100,000 population in Finland during 1996–2006, higher than previous estimates. PCR was most sensitive in detecting HSV-2 DNA from cerebrospinal fluid if the sample was taken 2–5 days after symptom onset.

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          Recurrent benign lymphocytic meningitis.

          Richard J. Whitley, Manal Shalabi (2006)
          Recurrent benign lymphocytic meningitis is a recurring, typically innocuous, painful form of aseptic meningitis. This syndrome is associated with transient neurological symptoms in one-half of afflicted patients. The causative agent is usually herpes simplex virus type 2, which can be confirmed by detection of viral DNA in the cerebrospinal fluid using polymerase chain reaction. Clinical disease resolves spontaneously; however, acyclovir, valacyclovir, and famciclovir have been administered to some patients for both episodic therapy and suppression of recurrences. This therapy is thought to be beneficial, although there is no controlled trial data to support efficacy and safety.
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            Transient urinary retention and chronic neuropathic pain associated with genital herpes simplex virus infection.

            Jorma Paavonen, Maija Haanpää (2004)
            Genital herpes (GH) causes genital ulcer disease, severe transient pain, and often paresthesias. Whether or not GH can cause urinary retention or chronic neuropathic pain is not well known. We present two immunocompetent patients with GH associated with neuropathic symptoms. We also review the literature on GH and associated neurologic problems. Patient 1 had primary herpes simplex virus (HSV)-2 infection with transient urinary retention and chronic bilateral neuropathic pain in the sacral area. Patient 2 had recurrent HSV-1 associated with unitaleral chronic neuropathic pain in the sacral area. Although transient urinary retention associated with GH is not uncommon, chronic neuropathic pain has not been reported previously. Our cases show that chronic neuropathic pain, that is "pain initiated or caused by a primary lesion or dysfunction in the nervous system," can follow genital HSV infection.
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              Increased detection rate in diagnosis of herpes simplex virus type 2 meningitis by real-time PCR using cerebrospinal fluid samples.

              Annika Tiveljung-Lindell, Lena Grillner, Elisabeth Aurelius … (2007)
              Efficient and sensitive diagnostic methods are needed in the management of virus infections in the central nervous system. There is a demand for an evaluation of the sensitivity of PCR methods for early diagnosis of meningitis due to herpes simplex type 2 (HSV-2) and varicella-zoster virus (VZV). The objective of this study was to evaluate real-time PCR in the detection of HSV-2 and VZV DNA from cerebrospinal fluid (CSF) for etiological diagnoses in clinically well-characterized cases of primary and recurrent aseptic meningitis. Samples from 110 patients, 65 of whom were diagnosed with or were strongly suspected of having HSV-2 meningitis and 45 with acute aseptic meningitis of unknown causes, were analyzed. Results were compared with the outcome of nested PCR for HSV-2 infection. Clinical parameters were analyzed in relation to CSF viral load. With real-time PCR, HSV-2 DNA was found in CSF from 80% (52/65) of patients with clinical HSV-2 meningitis compared to 72% (47/65) found by nested PCR. The sensitivity of real-time HSV-2 PCR was found to be 87% (33/38) in primary and 70% (19/27) in recurrent meningitis. The HSV-2 viral load was significantly higher in primary than in recurrent meningitis and correlated with the degree of inflammation. VZV DNA was detected in 2 of 45 samples (4.4%). Real-time PCR for the diagnosis of HSV-2 meningitis was evaluated in a large, clinically well-characterized sample of material and found to identify more cases than nested PCR in the group of patients with recurrent meningitis. Quantification of DNA enables further research of disease prognosis and treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): July 2009
                Volume: 15
                Issue: 7
                Pages: 1119-1122
                Affiliations
                [1]Helsinki University Central Hospital, Helsinki, Finland (K. Kallio-Laine, M. Seppänen, M. Lappalainen, V. Valtonen, M. Färkkilä, E. Kalso)
                [2]Orton Orthopedic Hospital, Helsinki (H. Kautiainen)
                [3]Haartman Institute, University of Helsinki, Helsinki (M.-L. Lokki)
                Author notes
                Address for correspondence: Katariina Kallio-Laine, Orton Orthopedic Hospital, Tenholantie 10, FI-00280, Helsinki, Finland; email: katariina.kallio-laine@ 123456helsinki.fi
                Article
                Publisher ID: 08-0716
                DOI: 10.3201/eid1507.080716
                PMC ID: 2744243
                PubMed ID: 19624935
                SO-VID: fb010449-0b42-41d7-9d14-155995230f7a
                History
                Categories
                Subject: Dispatch

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: aseptic,prevalence,herpes simplex virus type 2,finland,neurologic manifestations,meningitis,viruses,dispatch
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: aseptic, prevalence, herpes simplex virus type 2, finland, neurologic manifestations, meningitis, viruses, dispatch

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