The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Herpes Simplex Virus Infection as a Cause of Benign Recurrent Lymphocytic Meningitis

Davol G. Tedder; Rhoda Ashley; Kenneth L. Tyler; and Myron J. Levin
[+] Article, Author, and Disclosure Information

From the University of Colorado Health Sciences Center, The Children's Hospital, and the Denver Veterans Affairs Medical Center, Denver, Colorado; the University of Washington, Seattle, Washington. Requests for Reprints: Myron J. Levin, MD, Department of Pediatric Infectious Diseases, University of Colorado Health Sciences Center, 4200 East 9th Avenue C227, Denver, CO 80262. Acknowledgments: The authors thank Dr. Valerie G. Preston for providing the pGX146 construct and Cathie Wren for assistance with PCR studies. Grant Support: In part by a grant (NIH AI-20381) from the National Institute of Aging and by the Louis and Sydell Bruckner Memorial Fund of the University of Colorado School of Medicine. Dr. Tyler is supported by a merit grant from the Department of Veterans Affairs and by NINCDS Research Program Project grant P1NS32228A.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(5):334-338. doi:10.7326/0003-4819-121-5-199409010-00004
Text Size: A A A

Objective: To identify the role of herpes simplex virus (HSV) in causing benign recurrent lymphocytic meningitis.

Design: Prospective cohort study.

Setting: Tertiary referral center.

Patients: 20 consecutive patients with a provisional diagnosis of benign recurrent lymphocytic meningitis had cerebrospinal fluid specimens submitted between 1990 and 1993 to the diagnostic virology laboratory. Thirteen patients met our criteria for benign recurrent lymphocytic meningitis.

Measurements: Herpes simplex virus DNA was detected in cerebrospinal fluid specimens using the polymerase chain reaction, followed by hybridization with a HSV-specific DNA probe. Herpes simplex virus type 1 and type 2 DNA products were distinguished by digestion with restriction enzymes and analysis by gel electrophoresis. Anti-HSV antibodies in cerebrospinal fluid were detected by immunoblot.

Results: The patients had 3 to 9 attacks (mean, 4.6 attacks) of benign recurrent lymphocytic meningitis during periods ranging from 2 to 21 years (mean, 8.4 years). Three of 13 patients had known recurrent genital herpes. Cerebrospinal fluid analysis showed 48 to 1600 cells/µL, glucose levels of more than 2.22 mmol/L (40 mg/dL), and protein levels of 41 to 240 mg/dL (0.41 to 2.4 g/L). Herpes simplex virus DNA and anti-HSV antibodies were detected in cerebrospinal fluid samples in 11 of 13 patients (84.6%; 95% CI, 55% to 98%). Ten of these 11 patients had HSV type 2 DNA and HSV type 2 antibodies. One patient had HSV type 1 DNA and HSV type 1 antibodies in the cerebrospinal fluid. The remaining two patients had only anti-HSV type 2 antibodies.

Conclusions: Herpes simplex virus, predominantly HSV type 2, was the major agent causing benign recurrent lymphocytic meningitis that met our specified diagnostic criteria.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Journal Club
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.