Jensenius M, Myrvang B, Størvold G
Medisinsk avdeling, Lovisenberg Diakonale Sykehus, Oslo.
Tidsskr Nor Laegeforen. 1997 Jun 20;117(16):2316-8.
Aseptic meningitis is not an uncommon complication to primary genital herpes infection caused by herpes simplex virus type 2 (HSV-2). Compared with other types of viral meningitis, HSV-2-meningitis is associated with a significant rate of neurological complications in the acute stage. In addition, some patients will suffer from recurrent aseptic meningitis (Mollaret's meningitis) later. We describe six patients, five women and one man, age 26-35 years, with aseptic meningitis caused by HSV-2. All the patients showed serological evidence of primary herpes infection (negative HSV-IgG and/or positive HSV-IgM in serum samples). Polymerase chain reaction detected HSV-2 in cerebrospinal fluid in all five of five cases, while virus cultures were positive in two of the six cases. Only three patients showed clinical signs of simultaneous genital herpes infection. One patient, a 28-year-old female, developed transient autonomic nervous system dysfunction with urinary retention, constipation, and neuralgic pain in the buttocks, perineum and lower limbs. 13 months later she was hospitalised for a genital herpes infection with headache, parestesia and fever, but spinal fluid examination showed no abnormality.
无菌性脑膜炎是由2型单纯疱疹病毒(HSV-2)引起的原发性生殖器疱疹感染并不罕见的并发症。与其他类型的病毒性脑膜炎相比,HSV-2脑膜炎在急性期伴有较高的神经并发症发生率。此外,一些患者随后会患上复发性无菌性脑膜炎(莫拉雷脑膜炎)。我们描述了6例年龄在26至35岁之间、由HSV-2引起无菌性脑膜炎的患者,其中5名女性,1名男性。所有患者均有原发性疱疹感染的血清学证据(血清样本中HSV-IgG阴性和/或HSV-IgM阳性)。聚合酶链反应在5例中的5例脑脊液中检测到HSV-2,而病毒培养在6例中的2例呈阳性。只有3例患者有同时发生生殖器疱疹感染的临床体征。一名28岁女性患者出现短暂性自主神经系统功能障碍,伴有尿潴留、便秘以及臀部、会阴和下肢神经痛。13个月后,她因生殖器疱疹感染伴头痛、感觉异常和发热住院,但脑脊液检查未发现异常。