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Mollaret's meningitis (benign recurrent lymphocytic meningitis)

Etiology: - Herpes simplex virus type 2 (HSV2) & other viruses - Herpes simplex virus type 1 (HSV1) - Epstein-Barr virus (EBV) Pathology: - benign (self-limited) lymphocytic aseptic meningitis - linked to recurrences of Herpes simplex virus Clinical manifestations: - short-lived recurrent attacks of fever, stiff neck, headache & vomiting - 2-10 episodes of meningitis lasting 2-5 days followed by spontaneous recovery - seizures, hallucinations diplopia, cranial nerve palsy, or altered level of consciousness may also occur [1] Laboratory: - lumbar puncture & CSF analysis a) consistent with viral meningitis b) ghost cells c) Herpes simplex virus type 2 DNA Radiology: - neuroimaging with MRI if evidence of encephalitis (more commonly associated with HSV1) [1]

General

viral meningitis

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 14, 16 American College of Physicians, Philadelphia 2006, 2012
  2. Rubin SJ Mollaret's meningitis West J Med. 1994 May; 160(5):459-462 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1022498
  3. Mirakhur B and McKenna M Recurrent Herpes Simplex Type 2 Virus (Mollaret) Meningitis J Am Board Fam Pract. 2004 Jul-Aug;17(4):303-5 PMID: 15243021 http://www.jabfm.org/cgi/content/full/17/4/303
  4. Pearce JM. Mollaret's meningitis. Eur Neurol. 2008;60(6):316-7. Epub 2008 Oct 3. PMID: 18832846
  5. Mikdashi J, Kennedy S, Krumholz A. Recurrent benign lymphocytic (mollaret) meningitis in systemic lupus erythematosus. Neurologist. 2008 Jan;14(1):43-5. PMID: 18195657
  6. Sarikcioglu L, Sindel M. Pierre Mollaret (1898-1987) and his legacy to science. J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1135. PMID: 17878191
  7. Shalabi M, Whitley RJ. Recurrent benign lymphocytic meningitis. Clin Infect Dis. 2006 Nov 1;43(9):1194-7. Epub 2006 Sep 26 PMID: 17029141