2型单纯疱疹病毒所致无菌性脑膜炎伴突发耳聋：1例病例报告

Herpes simplex virus 2-induced aseptic meningitis presenting with sudden deafness: A case report.

作者信息

Liu Yuan-Cheng, Hsiao Shih-Hsuan, Chen Peir-Rong

机构信息

Department of Otolaryngology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan.

Department of Otolaryngology, Hualien Tzu Chi Hospital, and Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tzu Chi University, Hualien 970, Taiwan.

出版信息

World J Clin Cases. 2025 Mar 16;13(8):98320. doi: 10.12998/wjcc.v13.i8.98320.

DOI:10.12998/wjcc.v13.i8.98320

PMID:40094113

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11670016/

Abstract

BACKGROUND

Aseptic meningitis is defined as meningeal inflammation caused by various etiologies with negative cerebrospinal fluid (CSF) bacterial culture. The most common etiologies are viruses [enteroviruses, arboviruses, and herpes simplex virus type 2 (HSV-2)]. Aseptic meningitis can have various presentations, including sensorineural deafness. While sensorineural deafness from mumps meningoencephalitis has been reported, cases of HSV-2-induced hearing loss are rare. Herein, we report a case of HSV-2-induced meningitis that presented with sudden deafness.

CASE SUMMARY

A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day. Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss (thresholds 80-90 dB). After treatment with high-dose steroids for 1 week, he experienced an acute consciousness change with left hemiparesis. The laboratory data showed no significant abnormalities. Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemorrhage or obvious brain lesion. The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity. Hence, under the diagnosis of herpes meningoencephalitis, acyclovir was prescribed and his symptoms gradually resolved.

CONCLUSION

This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.

摘要

背景

无菌性脑膜炎定义为由各种病因引起的脑膜炎症，脑脊液（CSF）细菌培养呈阴性。最常见的病因是病毒[肠道病毒、虫媒病毒和2型单纯疱疹病毒（HSV - 2）]。无菌性脑膜炎可有多种表现，包括感音神经性耳聋。虽然已报道腮腺炎脑膜脑炎可导致感音神经性耳聋，但HSV - 2引起听力损失的病例罕见。在此，我们报告一例以突发耳聋为表现的HSV - 2感染性脑膜炎病例。

病例摘要

一名68岁男性突发左侧听力严重丧失1天。纯音听力图显示左侧突发感音神经性听力损失（阈值80 - 90分贝）。在接受高剂量类固醇治疗1周后，他出现急性意识改变并伴有左侧偏瘫。实验室检查数据无明显异常。头颅计算机断层扫描平扫及磁共振成像未发现颅内出血或明显脑病变。脑脊液分析和多重聚合酶链反应检测显示HSV - 2阳性。因此，在诊断为疱疹性脑膜脑炎后，给予阿昔洛韦治疗，其症状逐渐缓解。