Sato Rumi, Ayabe Mitsuyoshi, Shoji Hiroshi, Ichiyama Takashi, Saito Yumiko, Hondo Ryo, Eizuru Yoshito
First Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan.
J Infect. 2005 Nov;51(4):e217-20. doi: 10.1016/j.jinf.2005.02.018.
We report a 44-year-old Japanese woman with herpes simplex virus (HSV) type 2 recurrent meningitis (Mollaret's meningitis). The diagnosis was confirmed by nested polymerase chain reaction in her cerebrospinal fluid, but the patient's conventional HSV antibodies by complement fixation, neutralizing test or enzyme immunoassay showed low titres with low lymphoproliferative response. Several similar cases are discussed. Although the reason for the recurrent pathogenesis is uncertain, our report suggests that the low immune response including immune evasion may be involved in the pathogenesis of HSV type 2 recurrent meningitis. For this patient, long-term suppressive and patient-initiated therapies were conducted to prevent the recurrence of meningitis.
我们报告了一名44岁的日本女性，患有2型单纯疱疹病毒（HSV）复发性脑膜炎（莫拉雷脑膜炎）。通过对其脑脊液进行巢式聚合酶链反应确诊，但患者通过补体结合试验、中和试验或酶免疫测定法检测的传统HSV抗体滴度较低，淋巴细胞增殖反应也较低。文中讨论了几例类似病例。虽然复发性发病机制的原因尚不确定，但我们的报告表明，包括免疫逃逸在内的低免疫反应可能与2型HSV复发性脑膜炎的发病机制有关。对于该患者，进行了长期抑制性治疗和患者自主启动的治疗以预防脑膜炎复发。
