Demonstration of herpes simplex type 2 in the cerebrospinal fluid of two patients with recurrent lymphocytic meningitis.

AIMS: To investigate the aetiology of recurrent lymphocytic meningitis in two patients with a past history of recurrent genital herpes simplex infection.

METHODS

Cerebrospinal fluid (CSF) obtained from two patients during an acute recurrent episode of lymphocytic meningitis was analysed by polymerase chain reaction for the presence of herpes simplex DNA.

RESULTS

In both patients, the acute CSF was positive for herpes simplex type 2 DNA. A second CSF obtained 2 weeks later from one patient was negative for HSV DNA:

CONCLUSIONS

Herpes simplex type 2 may be an important cause of recurrent lymphocytic meningitis. Available evidence suggests that viral DNA is cleared from the CSF between episodes and supports active viral replication as the pathological mechanism. The recurrences of meningitis need not coincide with clinical recurrences of genital herpes.