Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC 27599-7594, USA.
Am J Emerg Med. 2011 Sep;29(7):840.e1-2. doi: 10.1016/j.ajem.2010.02.008. Epub 2010 May 1.
Mollaret meningitis is a syndrome characterized by recurrent bouts of meningitis that occur over a period of several years in an affected patient. Also known as recurrent lymphocytic meningitis, this entity involves repeated episodes of headache, stiff neck, fever, and cerebrospinal fluid pleocytosis. Herpes simplex virus type 2 is the most frequently implicated causative agent, and treatment involves the use of antiviral medications. We describe a case of Mollaret meningitis in a 47-year-old man who presented to the emergency department with his eighth episode of meningitis during a period of 20 years. Cerebrospinal fluid polymerase chain reaction testing for herpes simplex virus type 2 was positive, and further testing excluded other common viral, bacterial, and inflammatory causes of meningeal irritation. The patient's family history was significant for a brother who also had multiple episodes of aseptic meningitis during a period of several years. This represents the first published report of a possible familial association involving Mollaret meningitis. It is likely that Mollaret meningitis is underrecognized among emergency physicians, and improved recognition of this entity may limit unwarranted antibiotic use and shorten or eliminate unnecessary hospital admission.
莫拉雷尔氏脑膜炎是一种综合征，其特征为在受影响的患者中，在数年内反复发作脑膜炎。也称为复发性淋巴细胞性脑膜炎，该病症涉及反复发作的头痛、颈项强直、发热和脑脊液白细胞增多。单纯疱疹病毒 2 型是最常涉及的致病因子，治疗包括使用抗病毒药物。我们描述了一例 47 岁男性的莫拉雷尔氏脑膜炎病例，该患者在 20 年内出现了第 8 次脑膜炎发作而到急诊科就诊。脑脊液聚合酶链反应检测单纯疱疹病毒 2 型呈阳性，进一步检测排除了其他常见的病毒性、细菌性和炎症性脑膜刺激的原因。该患者的家族史显著，其兄弟在数年内也有多次无菌性脑膜炎发作。这是首例可能涉及莫拉雷尔氏脑膜炎的家族关联的已发表报告。莫拉雷尔氏脑膜炎很可能在急诊医生中被低估，提高对该病症的认识可能会限制不必要的抗生素使用，并缩短或消除不必要的住院治疗。
