Herpes meningitis
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Herpes meningitis | |
---|---|
Synonyms | N/A |
Pronounce | N/A |
Specialty | N/A |
Symptoms | Headache, fever, neck stiffness, photophobia, nausea, vomiting |
Complications | Seizures, encephalitis, hearing loss |
Onset | Sudden |
Duration | Varies |
Types | N/A |
Causes | Herpes simplex virus (HSV-1, HSV-2) |
Risks | Immunocompromised state, HIV/AIDS, neonates |
Diagnosis | Lumbar puncture, PCR testing of cerebrospinal fluid |
Differential diagnosis | Bacterial meningitis, Viral meningitis, Fungal meningitis |
Prevention | N/A |
Treatment | Antiviral drugs such as acyclovir |
Medication | N/A |
Prognosis | Generally good with treatment, but can be severe in immunocompromised individuals |
Frequency | Rare |
Deaths | N/A |
Herpes Meningitis is a form of viral meningitis caused by a herpes virus. Unlike bacterial meningitis, which is more severe and life-threatening, herpes meningitis is often less severe, but it still requires prompt medical attention and treatment. The condition involves the inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. This inflammation can lead to symptoms such as headache, fever, stiff neck, and sensitivity to light.
Causes
Herpes meningitis is primarily caused by two types of herpes viruses: Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2). HSV-1 is more commonly associated with oral herpes, which includes cold sores, while HSV-2 is typically related to genital herpes. However, both types of the virus can lead to herpes meningitis. The virus is transmitted through direct contact with the herpes sores or even the skin where the virus is shedding, even if no sores are present.
Symptoms
The symptoms of herpes meningitis can include:
- High fever
- Severe headache
- Stiff neck
- Sensitivity to light (photophobia)
- Nausea and vomiting
- Confusion or altered mental status
These symptoms can develop rapidly, often within hours to a couple of days after infection.
Diagnosis
Diagnosis of herpes meningitis involves a combination of clinical evaluation, laboratory tests, and sometimes imaging studies. The most definitive test is a lumbar puncture (spinal tap), where cerebrospinal fluid (CSF) is collected and analyzed for the presence of the herpes virus DNA through polymerase chain reaction (PCR) testing.
Treatment
Treatment for herpes meningitis typically involves antiviral medications such as acyclovir, which can help reduce the duration and severity of the illness. Supportive care, including hydration and pain management, is also important. Early treatment is crucial to prevent complications.
Prevention
Preventing herpes meningitis involves reducing the risk of herpes virus infections. Measures include avoiding direct contact with herpes sores, using barrier protection methods during sexual activity, and not sharing personal items that may have come into contact with the virus. For individuals with recurrent herpes infections, suppressive antiviral therapy may reduce the risk of developing meningitis.
Complications
While many individuals recover fully from herpes meningitis with appropriate treatment, some may experience complications such as:
- Recurrent episodes of meningitis, known as Mollaret's meningitis
- Neurological complications, including seizures or hearing loss
- Encephalitis, a more severe brain infection
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Contributors: Prab R. Tumpati, MD