User:Purplesquire/Herpesviral meningitis

HSV meningitis is meningitis associated with a herpes simplex virus (HSV) infection.

HSV is a common cause of viral meningitis, with HSV-2 the second most common cause of meningitis in adults. HSV-1 can also cause meningitis. HSV meningitis can occur either with the initial symptoms of a herpes infection or later upon re-activation of a prior infection.

Clinical presentation
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 people infected with HSV-2 have symptoms of meningitis with their initial infection, more commonly men than women.

Diagnosis
HSV meningitis can be diagnosed through a spinal tap, and PCR analysis of the cerberospinal fluid for HSV DNA. Not everyone with an HSV infection and meningitis tests positive for HSV DNA in the cerebrospinal fluid.

Treatment
HSV meningitis often spontaneously recovers. Treatment is usually supportive with the antivirals acyclovir and valacyclovir sometimes given.

Incidence
Herpes is a common cause of viral meningitis, with around one in twenty viral meningitis cases caused by a herpes simplex virus. HSV-2 is the most common cause of meningitis in adults. Herpesviral meningitis primarily affects people aged 35-40, the elderly, and women.

Recurrent Herpesviral meningitis
Herpesviral meningitis can sometimes be recurring, with HSV-2 causing most cases of recurrent benign lymphatic meningitis. Deficient T-cell immunity can make someone more prone to recurrent meningitis.

Mollaret's meningitis, a specific type of recurrent meningitis first described in 1944, has since been found to be most commonly caused by HSV-2.

Mollaret's Meningitis
HSV-2 is the most common cause of Mollaret's meningitis, a type of recurrent viral meningitis. This condition was first described in 1944 by French neurologist Pierre Mollaret. Recurrences usually last a few days or a few weeks, and resolve without treatment. They may recur weekly or monthly for approximately 5 years following primary infection.