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Use of images for any purpose including but not limited to research, commercial, personal, or non-commercial use is prohibited without prior written consent. BACKGROUND: Herpes simplex type-2 (HSV-2) causes both primary and recurrent lymphocytic meningitis, but optimal patient management is not well defined. Mollaret’s meningitis is an unusual and under-appreciated syndrome of benign, recurrent aseptic meningitis. This may involve herpes simplex virus type 1 (HSV1) , the virus that also causes cold sores. Herpes simplex virus type 2 (HSV-2) is known to cause aseptic meningitis, which can be recurrent. Herpes simplex virus infections occur in people of all races, of all ages, and of both sexes. Acetaminophen or ibuprofen may help reduce fever, muscle aches, and pain caused by the herpes virus sores. If you develop tender, painful sores on the lower back or buttocks, see a physician as soon as possible, since treatment is much more effective if started early.Recurrent outbreaks rarely require immediate medical attention.
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If you would like to obtain more information about these advertising practices and to make choices about online behavioral advertising, please click here. In 3 cases, patients had both antiHSV-1 and antiHSV-2 antibodies detected in serum, and the type of HSV-induced meningitis could not be determined. The diagnosis of HSV-2 infection is suggested when meningitis occurs simultaneously with genital lesions but may be obscure if genital lesions are not present or are not appreciated. HSV infection usually appears as small blisters or sores around the mouth, nose, genitals, buttocks, and lower back, though infections can develop almost anywhere on the skin. However, the 2 groups most commonly infected with HSV-2 include newborns, who contract it from their infected mothers during birth, and sexually active teenagers and adults, who contract it from their sexual partners.


These vesicles and pustules are usually quite fragile, so many people never notice them but instead see tiny open sores (ulcers). However, because some people have milder forms of genital herpes, you should also see a doctor for any recurring rash on the lower back or buttocks, even if you think it is from bug bites, ingrown hairs, or any other condition.If you have an underlying medical condition such as cancer or HIV, if you have undergone organ transplantation, or if you are pregnant, you are at higher risk for more serious complications. On occasion, however, a swab from the infected skin may be sent to the laboratory for viral culture, which takes a few days to grow.
HSV-1 and -2 infections are very common but most people affected have only minor symptoms or no symptoms at all. Herpes simplex virus type 2 (HSV-2) meningitis primarily develops during or following a primary genital HSV-2 infection that was acquired from sexual contact. Mollaret cells, which are a hallmark of Mollaret’s meningitis, were present in the CSF from two of the three patients.
Furthermore, these tender sores may come back periodically in the same sites.Infections with the herpes simplex virus are very contagious and are spread by direct contact with the skin lesions. Up to 1 in 5 Americans over the age of 12 may be infected with HSV-2.Remember that only 20% of people who are infected with the herpes simplex virus actually develop visible blisters or sores. Seek medical advice as soon as possible, especially if you are at high risk for complications. Blood tests may also be performed.Untreated herpes simplex virus infections will go away on their own, but medications can reduce the symptoms and shorten the duration of outbreaks. In cases of viral meningitis it is not always possible to identify the type of virus responsible for the disease (approximately 30-40 of patients have no pathogen identified).
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).
In all cases, herpes simplex virus type 2 DNA was present in the CSF during the acute illness as detected by polymerase chain reaction amplification, although viral cultures from CSF were all negative. That means that approximately 80% of people with HSV infections have not been diagnosed and are unaware of their condition.


Herpes simplex virus (HSV) remains an important cause of meningitis and encephalitis in adults, and polymerase chain reaction (PCR) -based tests are the gold standard for diagnosis. Patient 2 had chronic lymphocytic meningitis in the context of immunosuppressive medication and Mollaret cells in the cerebrospinal fluid. It is very unusual for adults to have encephalitis due to HSV type 2, but a difference in HSV type could account for the wide range of Ct values seen in the encephalitis cases. The herpesvirus family contains herpes simplex virus (HSV) types 1 and 2, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, and human herpesviruses 6 through 8. In severe cases of primary HSV-2 infection, people may develop fever, headache, neck stiffness, sensitivity to bright lights, muscle pain, painful urination, and discharge from the vagina or urethra.Repeat (recurrent) herpes simplex virus infections are often milder than the primary infection, though they look alike. Therefore, safe sex practices such as using a condom should be used between outbreaks, even if no sores are present on the lower back or buttocks. The more common clinical conditions include gingivostomatitis, keratitis, encephalitis, vesicular skin eruptions, aseptic meningitis, neonatal herpes, genital tract infections, and disseminated primary infection. However, some people never develop the symptoms of a primary HSV infection and may mistake a recurrent infection for a primary infection.
ABSTRACT A 34-year-old woman presented to hospital with symptoms of meningitis, later confirmed to be due to herpes simplex virus type 2. Herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) are two of the eight known viruses which comprise the human herpesvirus family.



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