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Mollaret’s Meningitis due to Herpes Simplex Virus 2: A Case Report and Review of the Literature

by Lanna, Federica , Gabrielli, Liliana , Campoli, Caterina , Montironi, Matteo , Giannella, Maddalena , Cantiani, Alessia , Petrisli, Evangelia , Venturoli, Simona , Pavoni, Matteo , Piccirilli, Giulia , Lazzarotto, Tiziana , Banchini, Isabella

in Acyclovir / Antibiotics / Antibodies / aseptic meningitis / Blood & organ donations / case studies / Cerebrospinal fluid / Chemical analysis / complications (disease) / Diagnostic systems / Diagnostic tests / Emergency medical care / Etiology / fever / Glucose / headache / Headaches / Herpes simplex / herpes simplex virus 2 / Herpes viruses / Human alphaherpesvirus 2 / Hypertension / Immunocompetence / Ischemia / Literature reviews / Meningitis / Mollaret’s meningitis / Mutation / Neurological complications / Neurological diseases / Patients / Peak load / Pleocytosis / quantitative polymerase chain reaction / Real time / Recurrent infection / women

2024

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2024

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2024

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Journal Article

Mollaret’s Meningitis due to Herpes Simplex Virus 2: A Case Report and Review of the Literature

Lanna, Federica,

Gabrielli, Liliana,

Campoli, Caterina,

Montironi, Matteo,

Giannella, Maddalena,

Cantiani, Alessia,

Petrisli, Evangelia,

Venturoli, Simona,

Pavoni, Matteo,

Piccirilli, Giulia,

Lazzarotto, Tiziana,

Banchini, Isabella

2024

Overview

Mollaret’s meningitis is a rare neurological disorder characterized by recurrent episodes of aseptic lymphocytic meningitis, often associated with herpes simplex virus 2 (HSV-2) infection. We report the case of a 39 y.o. Italian woman who experienced four episodes of aseptic lymphocytic meningitis between 2004 and 2023, diagnosed as Mollaret’s meningitis. In each episode, the patient presented with fever, severe headache and photophobia. In two episodes cutaneous vesicles in the left gluteal area preceding meningitis symptoms were also reported. A diagnostic evaluation included a physical–chemical analysis and a real-time PCR of the cerebrospinal fluid (CSF). The CSF presented pleocytosis with lymphocytic predominance and a positive HSV-2 load, with a peak of 1234 copies/mL. The patient was treated successfully with acyclovir, and the symptoms resolved without neurological sequelae. This case highlights the importance of comprehensive diagnostic testing and vigilant monitoring to manage Mollaret’s syndrome effectively.

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Publisher

MDPI AG

Subject

/ Blood & organ donations

/ case studies

/ Cerebrospinal fluid