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Herpes meningitis

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144:, meningitis caused by pathogens other than bacteria, is the most common form of meningitis with an estimate of 70 cases per 100,000 patients less than 1 year old, 5.2 cases per 100,000 patients 1 to 14 years of age, and 7.6 cases per 100,000 adults. When looking at the most common causes of meningitis, 8.3% are due to herpes simplex virus. HSV-2 specifically is the most common cause of meningitis in adults. 192:
Differential diagnoses are broad including other causes of meningitis (bacterial, fungal, drug-induced), systemic infection, vasculitis, auto-immune disease, and cancer. As such, patient presentation of fever, headache, stiff neck, and altered mental status is not sufficient information for diagnosis
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HSV-2 is the most common herpes virus that causes meningitis. This virus is transmitted via sexual contact and there are currently no vaccinations or cures for the disease. At the moment, there are no specific programs developed to prevent HSV-2 spread and prevention of disease is primarily done via
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Although guidelines strongly recommend acyclovir for treatment of herpes encephalitis, there are currently no such guidelines for managing herpes meningitis. Herpes meningitis is typically self-limiting over 2 weeks without treatment. However, empirical use of antiviral medications such as acyclovir
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Common symptoms include nausea, vomiting, neck-stiffness, photophobia, and severe frontal headaches. Patients with meningitis secondary to the HSV-2 virus may also present with genital lesions, although most cases of HSV-2 meningitis occur without symptoms of genital herpes. Around one fifth of
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is the gold standard for detection of herpes virus in patient CSF fluid due to high specificity and has been able to detect the HSV-2 virus in patients presenting without genital lesions as well as those experiencing recurrent meningitis.
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family - the most common amongst adults is HSV-2. Symptoms are self-limiting over 2 weeks with severe headache, nausea, vomiting, neck-stiffness, and photophobia. Herpes meningitis can cause
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is used to detect viral presence. Although symptoms are self-limiting, treatment with antiviral medication may be recommended to prevent progression to Herpes
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Herpesviral meningitis primarily affects people aged 35–40, the elderly, and women. Between 20% and 50% of cases have clinical recurrences.
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Tyler KL (2004). "Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's".
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is inflammation of the meninges, the protective tissues surrounding the spinal cord and brain, due to infection from viruses of the
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are considered in cases of suspected HSV meningitis to prevent progression to the more rapid and fatal HSV meningoencephalitis.
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findings in herpes meningitis present with lymphocytic pleocytosis, normal glucose, and normal-to-elevated protein.
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people infected with HSV-2 have symptoms of meningitis with their initial infection, more commonly men than women.
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Bacterial meningitis, viral meningitis, fungal meningitis, drug-induced meningitis, CNS abscess, vasculitis
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Noska, Amanda; Kyrillos, Ramona; Hansen, Glen; Hirigoyen, Diane; Williams, David N. (January 15, 2015).
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behavioral modification via condom use or through application of antiviral medications upon infection.
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T1W MRI of the brain demonstrating leptomeningeal enhancement consistent with meningitis
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Kohil, Amira; Jemmieh, Sara; Smatti, Maria K.; Yassine, Hadi M. (February 2021).
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results demonstrating aseptic meningitis pattern is necessary for diagnosis and
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Landry, Marie L.; Greenwold, Jennifer; Vikram, Holenarasipur R. (July 2009).
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is the most common cause of Mollaret's meningitis, a type of recurrent viral
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Ayoub, Houssein H.; Chemaitelly, Hiam; Abu-Raddad, Laith J. (July 8, 2020).
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Roberts, James R.; Custalow, Catherine B.; Thomsen, Todd W., eds. (2019).
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Roberts and Hedges' clinical procedures in emergency medicine
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Spear, Patricia G.; Longnecker, Richard (October 2003).
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Mount, Hillary R.; Boyle, Sean D. (September 1, 2017).
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Logan, Sarah A E; MacMahon, Eithne (January 5, 2008).
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Philadelphia: Elsevier. 365: 363: 361: 64:Headache, fever, neck stiffness, photophobia 2124: 2110: 2102: 1824: 1604: 1369:Progressive multifocal leukoencephalopathy 1339: 1112: 1098: 1090: 1036: 29: 20: 1240:Extranodal NK/T-cell lymphoma, nasal type 1010: 992: 904: 844: 467: 403: 341: 284: 2245:Herpes simplex virus–associated diseases 243: 500:Current Opinion in Infectious Diseases 7: 1390:Subacute sclerosing panencephalitis 452:10.7861/clinmed.2022-cme-meningitis 72:Viruses of the herpesviridae family 326:10.1128/JVI.77.19.10179-10185.2003 117:, a form of recurrent meningitis. 14: 1709:Severe acute respiratory syndrome 1235:Follicular dendritic cell sarcoma 786:Current Pain and Headache Reports 647:Rozenberg, Flore (October 2020). 1695:Middle East respiratory syndrome 877:Journal of Clinical Microbiology 747:The American Journal of Medicine 694:Corey, Lawrence (June 1, 1983). 204:DNA analysis techniques such as 253:"Viral meningitis: an overview" 2135:and other diseases of meninges 1294:Adult T-cell leukemia/lymphoma 1280:Splenic marginal zone lymphoma 310:"Herpesvirus Entry: an Update" 100:Symptom management, antivirals 1: 889:10.1128/jcm.35.3.691-696.1997 82:CSF findings, lumbar puncture 1499:Tropical spastic paraparesis 1404:Lymphocytic choriomeningitis 934:Clinical Infectious Diseases 759:10.1016/j.amjmed.2009.02.017 512:10.1097/QCO.0000000000000922 1862:Cytomegalovirus esophagitis 1782:Human parainfluenza viruses 1455:Ramsay Hunt syndrome type 2 700:Annals of Internal Medicine 388:10.1136/bmj.39409.673657.AE 2266: 819:Sendi P, Graber P (2006). 712:10.7326/0003-4819-98-6-958 269:10.1007/s00705-020-04891-1 163: 159: 1526:Cytomegalovirus retinitis 798:10.1007/s11916-017-0635-7 614:American Family Physician 206:polymerase chain reaction 127:polymerase chain reaction 37: 28: 1628:Infectious mononucleosis 1445:Chandipura vesiculovirus 1275:Hepatocellular carcinoma 1220:Nasopharyngeal carcinoma 1153:Hepatocellular carcinoma 558:. 11. Suppl 2: 57A–64A. 232:Herpesviral encephalitis 1424:Encephalitis lethargica 1125:viral systemic diseases 994:10.3390/vaccines8030366 821:"Mollaret's meningitis" 1796:Human orthopneumovirus 1450:Herpesviral meningitis 1411:Arbovirus encephalitis 782:"Recurrent Meningitis" 88:Differential diagnosis 1254:Merkel-cell carcinoma 665:10.1684/vir.2020.0862 166:Mollaret's meningitis 160:Mollaret's Meningitis 151:Clinical presentation 115:Mollaret's meningitis 1899:Adenovirus infection 1363:Human polyomavirus 2 1192:Oropharyngeal cancer 257:Archives of Virology 2224:Meningoencephalitis 1485:Post-polio syndrome 1121:Infectious diseases 837:10.1503/cmaj.051688 320:(19): 10179–10185. 314:Journal of Virology 199:Cerebrospinal fluid 131:Meningoencephalitis 123:cerebrospinal fluid 1618:Epstein–Barr virus 1588:Respiratory system 1225:Burkitt's lymphoma 946:10.1093/cid/ciu772 372:"Viral meningitis" 142:Aseptic meningitis 49:Infectious disease 2232: 2231: 2099: 2098: 2061: 2060: 1812: 1811: 1743:Influenza virus A 1660:Human coronavirus 1550: 1549: 1540:Herpes of the eye 1087: 1086: 591:978-0-323-35478-3 440:Clinical Medicine 107:Herpes meningitis 104: 103: 78:Diagnostic method 24:Herpes meningitis 18:Medical condition 2257: 2126: 2119: 2112: 2103: 1825: 1820:digestive system 1737:Orthomyxoviridae 1703:SARS coronavirus 1689:MERS coronavirus 1605: 1417:Orthomyxoviridae 1340: 1306:Immune disorders 1230:Hodgkin lymphoma 1206:Kaposi's sarcoma 1114: 1107: 1100: 1091: 1037: 1025: 1024: 1014: 996: 972: 966: 965: 925: 919: 918: 908: 868: 859: 858: 848: 816: 810: 809: 777: 771: 770: 738: 732: 731: 691: 685: 684: 644: 638: 637: 605: 596: 595: 577: 568: 567: 551: 540: 539: 491: 482: 481: 471: 431: 418: 417: 407: 367: 356: 355: 345: 305: 299: 298: 288: 248: 33: 21: 2265: 2264: 2260: 2259: 2258: 2256: 2255: 2254: 2235: 2234: 2233: 2228: 2212: 2136: 2130: 2100: 2095: 2057: 2037: 1945: 1919:Gastroenteritis 1877: 1874:Gastroenteritis 1868: 1856:Cytomegalovirus 1819: 1808: 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1658: 1634: 1616: 1571:Pericarditis 1563: 1532: 1518: 1491: 1472: 1430: 1415: 1396: 1382: 1361: 1344:Encephalitis 1313: 1286: 1267: 1246: 1212: 1198: 1159: 1145: 1067: 1052: 984: 980: 970: 937: 933: 923: 880: 876: 831:(12): 1710. 828: 824: 814: 789: 785: 775: 750: 746: 736: 703: 699: 689: 656: 652: 642: 617: 613: 581: 555: 503: 499: 443: 439: 379: 375: 317: 313: 303: 260: 256: 246: 220: 216: 203: 191: 169: 154: 146: 140: 137:Epidemiology 106: 105: 15: 2182:Herpesviral 2165:Haemophilus 2160:Tuberculous 1940:Coronavirus 1681:Common cold 1593:acute viral 1576:Myocarditis 1420:(probable) 1172:Anal cancer 179:neurologist 2250:Meningitis 2239:Categories 2142:Meningitis 2133:Meningitis 2067:Urogenital 1933:Astrovirus 1893:Adenovirus 1717:SARS-CoV-2 1474:Poliovirus 1349:meningitis 987:(3): 366. 238:References 175:meningitis 2155:Bacterial 1978:RNA virus 1959:DNA virus 1951:Hepatitis 1926:Norovirus 1914:Rotavirus 1908:RNA virus 1887:DNA virus 1833:Esophagus 1761:Influenza 1647:RNA virus 1609:DNA virus 1378:RNA virus 1357:DNA virus 1263:RNA virus 1141:DNA virus 1133:Oncovirus 1003:2076-393X 954:1537-6591 897:0095-1137 806:1531-3433 720:0003-4819 673:1267-8694 653:Virologie 626:1532-0650 536:258299272 520:0951-7375 460:1470-2118 396:0959-8138 334:0022-538X 277:0304-8608 213:Treatment 188:Diagnosis 97:Treatment 53:Neurology 44:Specialty 2076:BK virus 1879:diarrhea 1723:COVID-19 1465:Myelitis 1021:32650385 981:Vaccines 962:25273082 855:16754896 767:19559173 681:33111702 634:28925647 564:15319091 528:37093042 478:36507811 414:18174598 352:12970403 295:33392820 226:See also 60:Symptoms 2201:Aseptic 1829:Pharynx 1333:Central 1012:7564812 915:9041414 846:1471823 728:6344712 469:9594998 405:2174764 286:7779091 2189:Fungal 1493:HTLV-I 1438:Rabies 1288:HTLV-I 1019:  1009:  1001:  960:  952:  913:  906:229652 903:  895:  853:  843:  804:  765:  726:  718:  679:  671:  632:  624:  588:  562:  556:Herpes 534:  526:  518:  476:  466:  458:  412:  402:  394:  350:  343:228481 340:  332:  293:  283:  275:  69:Causes 2217:Other 2177:Viral 2089:Mumps 1848:Mumps 1818:Human 1248:MCPyV 1078:054.3 1063:B00.3 792:(7). 532:S2CID 171:HSV-2 121:with 1803:hMPV 1675:OC43 1671:HKU1 1667:NL63 1663:229E 1321:AIDS 1200:KSHV 1073:9-CM 1017:PMID 999:ISSN 958:PMID 950:ISSN 911:PMID 893:ISSN 851:PMID 825:CMAJ 802:ISSN 763:PMID 724:PMID 716:ISSN 677:PMID 669:ISSN 630:PMID 622:ISSN 586:ISBN 560:PMID 524:PMID 516:ISSN 474:PMID 456:ISSN 410:PMID 392:ISSN 348:PMID 330:ISSN 291:PMID 273:ISSN 193:and 2083:MuV 2052:CBV 2027:HEV 2015:HDV 2003:HCV 1991:HAV 1984:CBV 1965:HBV 1842:MuV 1773:V, 1565:CBV 1534:HSV 1511:Eye 1398:LCV 1384:MeV 1315:HIV 1269:HCV 1214:EBV 1161:HPV 1147:HBV 1069:ICD 1054:ICD 1007:PMC 989:doi 942:doi 901:PMC 885:doi 841:PMC 833:doi 829:174 794:doi 755:doi 751:122 708:doi 661:doi 508:doi 464:PMC 448:doi 400:PMC 384:doi 380:336 376:BMJ 338:PMC 322:doi 281:PMC 265:doi 261:166 2241:: 1779:: 1740:: 1734:, 1657:: 1655:IV 1432:RV 1123:– 1076:: 1061:: 1058:10 1015:. 1005:. 997:. 983:. 979:. 956:. 948:. 938:60 936:. 932:. 909:. 899:. 891:. 881:35 879:. 875:. 863:^ 849:. 839:. 827:. 823:. 800:. 790:21 788:. 784:. 761:. 749:. 745:. 722:. 714:. 704:98 702:. 698:. 675:. 667:. 657:24 655:. 651:. 628:. 618:96 616:. 612:. 600:^ 572:^ 544:^ 530:. 522:. 514:. 504:36 502:. 498:. 486:^ 472:. 462:. 454:. 444:22 442:. 438:. 422:^ 408:. 398:. 390:. 378:. 374:. 360:^ 346:. 336:. 328:. 318:77 316:. 312:. 289:. 279:. 271:. 259:. 255:. 133:. 51:, 2125:e 2118:t 2111:v 2034:) 2032:E 2030:( 2022:) 2020:D 2018:( 2010:) 2008:C 2006:( 1998:) 1996:A 1994:( 1972:) 1970:B 1968:( 1921:) 1917:( 1876:/ 1831:/ 1763:/ 1755:D 1753:/ 1751:C 1749:/ 1747:B 1745:/ 1732:V 1673:/ 1669:/ 1665:/ 1626:/ 1597:/ 1590:/ 1346:/ 1113:e 1106:t 1099:v 1071:- 1056:- 1046:D 1023:. 991:: 985:8 964:. 944:: 917:. 887:: 857:. 835:: 808:. 796:: 769:. 757:: 730:. 710:: 683:. 663:: 636:. 594:. 566:. 538:. 510:: 480:. 450:: 416:. 386:: 354:. 324:: 297:. 267::

Index


Specialty
Infectious disease
Neurology
Symptoms
Diagnostic method
Differential diagnosis
Herpesviridae
Mollaret's meningitis
Lumbar puncture
cerebrospinal fluid
polymerase chain reaction
Meningoencephalitis
Aseptic meningitis
Mollaret's meningitis
HSV-2
meningitis
neurologist
Pierre Mollaret
lumbar puncture
Cerebrospinal fluid
polymerase chain reaction
Herpesviral encephalitis
"Viral meningitis: an overview"
doi
10.1007/s00705-020-04891-1
ISSN
0304-8608
PMC
7779091

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