Increased Detection Rate in Diagnosis of Herpes Simplex Virus Type 2 Meningitis by Real-Time PCR Using Cerebrospinal Fluid Samples

HSV-2 meningoencephalitis in an immunocompetent young man: what is the pathogenesis and what is the treatment?

“…He had two normal brain MRI, whereas in HSV-1 associated HSE cases [8], necrotic brain lesions are almost constant. Interestingly, his CSF protein level was unusually elevated compared with the median protein level observed in HSV-2 meningitis [21], suggesting a marked alteration of the brain blood barrier which may play a role in encephalitis [1,16]. Moreover, his CSF HSV-2 load was unusually high compared with levels reported in HSV-2 meningitis [21], and his CSF IFN response was markedly higher than in a series of HSV-1 encephalitis cases [8].…”

Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi

“…Our failure to detect HSV-2 and VZV in this cohort was unexpected, since both are common identifiable causes of viral meningitis in Western industrialised countries [16, 17]. It may be that the spectrum of causes of herpes viral meningitis in a population with high HIV prevalence is different to that in Western industrialised countries.…”

Increased Cell-Mediated Immune Responses in Patients with Recurrent Herpes Simplex Virus Type 2 Meningitis

“…Clearly, oligoclonal T cells are present in infected ganglia (14,46) even during latency (44), and virus may enter either via neuron-neuron interactions or from circulation during viremia (15). A higher incidence in women may, in this view of immune-mediated pathology, reflect a generally higher immune reactivity in females (8,11). Accordingly, healthy women have been shown to respond more efficiently upon stimulation through TLR7 (28), with a subsequent higher T cell response, than men.…”