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Hwang, Kim, Park, Park, Cho, Park, and Cho: Recurrent Herpes Simplex Virus Type-2 Meningitis in an Adolescent Girl
Case Report

Korean J Community Nutr 2014;16(2):77-80.

Published online: 18 January 2014

DOI: https://doi.org/10.14253/kjcn.2014.16.2.77

Recurrent Herpes Simplex Virus Type-2 Meningitis in an Adolescent Girl

YunSu Hwang1, YoungSeo Kim1, HyunYoung Park1, HyungJong Park1, JiHyun Cho2, DoSim Park2, KwangHo Cho1

1Department of Neurology, Wonkwang University School of Medicine Institute of Wonkwang Medical Science and Regional Cardiocerebrovascular Center; Korea

2Department of Laboratory Medicine, Wonkwang University School of Medicine, Iksan, Korea

Address for correspondence; HyunYoung Park Department of Neurology, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 570-711, Korea Tel: +82-63-859-1410 Fax: +82-63-842-7379 E-mail: hypppark@hanmail.net

Received 16 July 2014       Revised 18 October 2014       Accepted 11 November 2014

Copyright © 2014 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Herpes simplex virus type 2 (HSV2) meningitis primarily develops during or following a primary genital HSV2 in-fection that was acquired from sexual contact or through the birth canal during delivery from mother. We describe a 15 year old virgin without history of previous herpes simplex infection who developed 2 episodes of HSV2 meningitis. Although recurrent meningitis due to HSV is primarily seen in young or sexually active adults. HSV2 meningitis should be in the differential diagnosis of recurrent meningitis in adolescent patients. (Korean J Clin Neurophysiol 2014;16: 77-80)

Keywords: Recurrent meningitis, Herpes simplex meningitis, Mollaret’s meningitis

REFERENCES

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Figure 1.
Agarose gel electrophoresis showing multiplex polymerase chain reaction amplified products from the ser-ebrospinal fluid. Lane 1 shows molecular weight markers with target sizes in base pairs. Lane 2 and 3 show the patient’s positive results for HSV-2 in two consecutive episodes. Lane 4 is a distilled water negative control. IC; internal control, CMV; cytomegalovirus, HHV6; human herpes vi rus 6, EBV; Epstein-Barr virus, HSV; herpes simplex virus, VZV; varicella-zoster virus.
kjcn-16-77f1.tif
Table 1.
CSF analysis of the previous three episodes and current two episodes
No. 1 Feb 14, 2003 No. 2 May 14, 2005 No. 3 Apr 23, 2007 No. 4 Sep 7, 2011 No. 5 Dec 12, 2011
CSF
Sampling period, hr* 48 24 24 48 24
WBC, /mm3 850 1,410 320 105 80
Neutrophil, % 10 40 10 40 10
Lymphocyte, % 90 60 90 60 90
Glucose (a/b†), mg/dL 60/199 65/167 65/150 63/106 60/106
Protein, mg/dL 45.9 88.3 39 88.3 39
Color Colorless Colorless Colorless Colorless Colorless
Pressure, cm H2O 20 12 15 16 16
Ab detection‡ - - - - -
Culture and Gram staining - - - - -
India ink - - - - -
AFB stain and culture - - - - -
Multiplex PCR - - - HSV type-2 HSV type-2
Serum
Serum HSV IgG (EIA) - -
Serum HSV IgG (EIA) - -
Serum Autoimmune antibodies11 - -

CSF; cerebrospinal fluid, WBC; white blood cell, AFB; acid fast bacilli, PCR; polymerase chain reaction, HSV; herpes simplex virus, IgG; immunoglobulin G, EIA; enzyme immunoassay.

After first symptoms, †Serum/glucose, ‡Neisseria meningitidis B, ACYW 135, Escherichia coli K1, Haemophilus influenzae B, Streptococcus pneumonia, Group B streptococcus, cryptococcus, §Aerobic, anaerobic, fungus, Antinuclear antibody, anti-smith antibody, anti-ribonucleoprotein antibody, anti-Ro/La antibody, anti-topoisomerase antibody, anti Jo-1 antibody, anti-centromere antibody, anti-ribosomal protein antibody.

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