Jpn. J. Infect. Dis., 55, 85-88, 2002

Short Communication

Recurrent Herpes Simplex Virus Type 2 Meningitis: A Case Report of Mollaret's Meningitis

Yuki Kojima, Hideyuki Hashiguchi, Tomoko Hashimoto, Sadatoshi Tsuji, Hiroshi Shoji¹* and Yukumasa Kazuyama²

Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Iseigaoka 1-1, Yahatanishi-ku, Kitakyusyu 807-8555, ¹First Department (Neurology) of Internal Medicine, Kurume University School of Medicine, Asahimachi 67, Kurume 830-0011 and ²Kitazato-Otsuka Biomedical Assay Laboratory, Sagamihara, Kanagawa 228-8555, Japan.

(Received May 7, 2002. Accepted July 26, 2002)

SUMMARY: It is well known that herpes simplex virus (HSV) type 2 produces acute meningitis, while HSV type 2 rarely causes recurrent meningitis (Mollaret's meningitis). We report the history of a 40-year-old patient with recurrent HSV type 2 meningitis (Mollaret's meningitis). The patient had seven episodes of meningeal symptoms within a 7-year period. In the seventh episode, HSV type 2 DNA was confirmed by nested polymerase chain reaction (PCR) with the cerebrospinal fluid (CSF). A real-time quantitative PCR study of the first CSF sample detected 2,000 copies of the HSV genome, which rapidly disappeared following treatment with acyclovir. The present case may be the first case of HSV type 2 Mollaret's meningitis to be documented in Japan. In our case, HSV serum antibody titers were at low levels during the whole course of the disease. The possible pathophysiology of this case is discussed.

*Corresponding author: Fax: +81-942-31-7703, E-mail: hshoji@med.kurume-u.ac.jp

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