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Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female

Aseptic meningitis is most commonly caused by herpes simplex virus (HSV), most often viral subtype 2. While typical meningeal symptoms include headache, photophobia/phonophobia, and nuchal rigidity, these are often much less severe than in bacterial meningitis. Rarely, patients may develop recurrent...

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Detalles Bibliográficos
Autores principales: Kirkland, Zachary, Jeffery, Ranese E, Conte, Jorge, George, Justin, Mercado, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755614/
https://www.ncbi.nlm.nih.gov/pubmed/33376637
http://dx.doi.org/10.7759/cureus.11623
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author Kirkland, Zachary
Jeffery, Ranese E
Conte, Jorge
George, Justin
Mercado, Roberto
author_facet Kirkland, Zachary
Jeffery, Ranese E
Conte, Jorge
George, Justin
Mercado, Roberto
author_sort Kirkland, Zachary
collection PubMed
description Aseptic meningitis is most commonly caused by herpes simplex virus (HSV), most often viral subtype 2. While typical meningeal symptoms include headache, photophobia/phonophobia, and nuchal rigidity, these are often much less severe than in bacterial meningitis. Rarely, patients may develop recurrent episodes of aseptic meningitis, sometimes with years between each presentation. A minimum of three episodes with at least one documented viral identification is classified as Mollaret meningitis. First described by Mollaret in 1945, the condition is self-limiting and often requires no intervention or suppressive antivirals. In fact, antiviral therapy may increase frequency of presentation. Our patient presented for her third bout of meningitis, with viral polymerase chain reaction positive for HSV-2 on lumbar puncture. The patient was successfully managed with supportive care without further suppressive antiviral therapy. As the disease is self-limiting, clinician education can mediate patient expectations, reduce unnecessary antiviral usage, and decrease superfluous healthcare resource utilization.
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spelling pubmed-77556142020-12-28 Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female Kirkland, Zachary Jeffery, Ranese E Conte, Jorge George, Justin Mercado, Roberto Cureus Internal Medicine Aseptic meningitis is most commonly caused by herpes simplex virus (HSV), most often viral subtype 2. While typical meningeal symptoms include headache, photophobia/phonophobia, and nuchal rigidity, these are often much less severe than in bacterial meningitis. Rarely, patients may develop recurrent episodes of aseptic meningitis, sometimes with years between each presentation. A minimum of three episodes with at least one documented viral identification is classified as Mollaret meningitis. First described by Mollaret in 1945, the condition is self-limiting and often requires no intervention or suppressive antivirals. In fact, antiviral therapy may increase frequency of presentation. Our patient presented for her third bout of meningitis, with viral polymerase chain reaction positive for HSV-2 on lumbar puncture. The patient was successfully managed with supportive care without further suppressive antiviral therapy. As the disease is self-limiting, clinician education can mediate patient expectations, reduce unnecessary antiviral usage, and decrease superfluous healthcare resource utilization. Cureus 2020-11-22 /pmc/articles/PMC7755614/ /pubmed/33376637 http://dx.doi.org/10.7759/cureus.11623 Text en Copyright © 2020, Kirkland et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Kirkland, Zachary
Jeffery, Ranese E
Conte, Jorge
George, Justin
Mercado, Roberto
Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female
title Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female
title_full Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female
title_fullStr Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female
title_full_unstemmed Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female
title_short Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret's Meningitis in a 30-Year-Old Female
title_sort recurrent aseptic meningitis from herpes simplex virus-2: mollaret's meningitis in a 30-year-old female
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755614/
https://www.ncbi.nlm.nih.gov/pubmed/33376637
http://dx.doi.org/10.7759/cureus.11623
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