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Herpes simplex virus type 2 (HSV-2) meningitis dogmatically is benign and self-limited in the immune competent patient.
ReferencesAurelius E, Forsgren M, Gille E, Skoldenberg B (2002) Neurologic morbidity after herpes simplex virus type 2 meningitis: a retrospective study of 40 patients. JavaScript is currently disabled, this site works much better if you enable JavaScript in your browser. The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Herpes simplex virus (HSV) is an enveloped double-stranded DNA virus that is a common pathogen in humans. Primary infection with HSV results in either oropharyngeal infection or genital ulcer disease.
As a busy clinician, balancing work life and home life and personal time generally means that something gives.
However, we describe how left untreated HSV-2 meningitis can be complicated by vasculitis and both ischemic and hemorrhagic stroke.
Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. There are 2 subtypes, HSV-1 and HSV-2, which are distinguished by their different DNA composition. HSV-1 and HSV-2 establish latency in the trigeminal dorsal root ganglia and the lumbosacral ganglia, respectively, after primary infection.1 These viruses can be reactivated and cause recurrent disease. We report a 57-year-old woman with lymphocytic meningitis complicated by ischemic stroke and intracerebral hemorrhage in the setting of vasculopathy and HSV-2 DNA detected in CSF successfully treated with acyclovir and corticosteroids.
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Neither primary nor recurrent HSV disease is usually life-threatening, and HSV disease is usually more a cause of discomfort than significant morbidity and mortality.
Secreted portion of glycoprotein G of herpes simplex virus type 2 is a novel antigen for type-discriminating serology.
Herpes simplex virus from the lower respiratory tract in adult respiratory distress syndrome. Herpes simplex virus shedding among human immunodeficiency virus-negative men who have sex with men: site and frequency of shedding. Herpes simplex virus pneumonia: clinical, virologic, and pathologic features in 20 patients. The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics. Herpes simplex virus—the most frequently isolated pathogen in the lungs of patients with severe respiratory distress. Verrucous varicella zoster virus lesions associated with acquired immunodeficiency syndrome.
Immunohistochemical study on the infection of herpes simplex virus, human cytomegalovirus, and Epstein-Barr virus in secondary diffuse interstitial pneumonia. Disseminated cutaneous herpes simplex virus type-1 with interstitial pneumonia as a first presentation of AIDS. Acyclovir-resistant herpes simplex virus infections in patients with the acquired immunodeficiency syndrome.
Altered sensitivity to antiviral drugs of herpes simplex virus isolates from a patient with the acquired immunodeficiency syndrome. Subsequent angiographic magnetic resonance imaging revealed improvement in the vasculopathy after treatment.


Uncommonly, HSV infection can be potentially fatal, as in encephalitis, disseminated disease, or neonatal infection.3 Pulmonary infection remains a significant cause of morbidity and mortality in persons infected with HIV. This case demonstrates that HSV-2 meningitis may take a less benign course and further provides the first evidence of angiographic improvement in addition to clinical improvement after definitive treatment.
The pathogens most frequently isolated are Pneumocystis jiroveci, Streptococcus pneumoniae, Mycobacterium tuberculosis, and cytomegalovirus. The patient had been seen in the emergency department 2 weeks before with similar complaints and discharged home with a prescription for azithromycin, which he never had filled.
A diagnosis of HIV infection had recently been made, but the patient had not yet made a follow-up appointment.
Findings on physical examination were notable for oral candidiasis and decreased lung sounds bilaterally.
Chest radiograph demonstrating bilateral interstitial infiltrates.A chest radiograph showed bilateral interstitial infiltrates (Figure 1).
Azithromycin and ceftriaxone were also administered to cover potential community-acquired pneumonia pathogens. He underwent bronchoscopy with bronchoalveolar lavage on hospital day 2; all cultures, including those for bacteria, viruses, and mycobacteria, as well as those using acid-fast bacilli smear and silver stain, yielded negative results.




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