Recurrent benign lymphocytic (Mollaret’s) meningitis due to herpes simplex virus type 2

Abstract

We present a rare case of Mollaret’s meningitis in a young patient with seven prior episodes of recurrent meningitis. The patient presented with headache, fever, neck stiffness, nausea, and vomiting. Brain imaging revealed no acute abnormalities. Lumbar puncture revealed elevated nucleated cells with lymphocytic predominance. The patient was started on antimicrobials including acyclovir. Cerebrospinal fluid polymerase chain reaction was positive for herpes simplex virus type 2. Her 2-day hospital course was uncomplicated, and she was discharged in good condition. Mollaret’s meningitis, also known as recurrent benign lymphocytic meningitis, is a rare clinical disorder characterized by at least three recurrent episodes of meningitis associated with spontaneous recovery with or without antiviral therapy. Herpes simplex virus type 2 has frequently been implicated in the setting of this illness.

Keywords:

• HSV-2
• Mollaret’s meningitis
• recurrent benign lymphocytic meningitis
• recurrent meningitis