Your browser doesn't support javascript.
loading
Herpes Simplex Virus 2 Meningitis in Adults: A Prospective, Nationwide, Population-Based Cohort Study.
Jakobsen, Anna; Skov, Marie Thaarup; Larsen, Lykke; Trier Petersen, Pelle; Brandt, Christian; Wiese, Lothar; Hansen, Birgitte Rønde; Lüttichau, Hans Rudolf; Tetens, Malte Mose; Helweg-Larsen, Jannik; Storgaard, Merete; Nielsen, Henrik; Bodilsen, Jacob.
Afiliación
  • Jakobsen A; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Skov MT; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Larsen L; Research Unit for Infectious Diseases, Odense University Hospital, Odense, Denmark.
  • Trier Petersen P; University of Southern Denmark, Odense, Denmark.
  • Brandt C; Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Hillerød, Denmark.
  • Wiese L; Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Hillerød, Denmark.
  • Hansen BR; Department of Infectious Diseases, Sjælland University Hospital, Roskilde, Denmark.
  • Lüttichau HR; Department of Infectious Diseases, Sjælland University Hospital, Roskilde, Denmark.
  • Tetens MM; Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark.
  • Helweg-Larsen J; Department of Medicine and Infectious Diseases, Herlev Gentofte Hospital, Copenhagen, Denmark.
  • Storgaard M; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
  • Nielsen H; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
  • Bodilsen J; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmarkand.
Clin Infect Dis ; 75(5): 753-760, 2022 09 14.
Article en En | MEDLINE | ID: mdl-34979025
ABSTRACT

BACKGROUND:

Data on the clinical presentation are scarce and prognostic factors of herpes simplex virus type 2 (HSV-2) meningitis remain unknown.

METHODS:

Prospective, nationwide, population-based database identifying all adults treated for HSV-2 meningitis at departments of infectious diseases in Denmark from 2015 to 2020. Unfavorable outcome was defined as Glasgow Outcome Scale (GOS) scores of 1-4 and Extended GOS scores of 1-6. Modified Poisson regression was used to compute relative risks with 95% confidence intervals for unfavorable outcome.

RESULTS:

HSV-2 meningitis was diagnosed in 205 patients (76% female; median age [interquartile range (IQR)], 35 [27-49] years) yielding an incidence of 0.7/100 000 population/y. Common symptoms were headache (195 of 204 patients [95%]), photophobia or phonophobia (143 of 188 [76%]), and neck stiffness (106 of 196 [54%]). The median (IQR) time to lumbar puncture was 2.0 (1-4.8) hours, and the median cerebrospinal fluid (CSF) leukocyte count was 360 (166-670) × 10 × 6/L, with a mononuclear predominance of 97% (91%-99%). Lumbar puncture was preceded by brain imaging in 61 of 205 patients (30%). Acyclovir or valacyclovir was administered in 197 of 205 patients (96%) for a median (IQR) of 10 (7-14) days. Unfavorable outcome was observed in 64 of 205 patients (31%) at discharge and 19 of 181 (11%) after 6 months and was not associated with female sex (relative risk [95% confidence interval], 1.08 [.65-1.79]), age ≥35 years (1.28 [.83-1.97]), immunocompromise (1.07 [.57-2.03]), or CSF leukocyte count >1000 × 10 × 6/L (0.78 [.33-1.84]).

CONCLUSIONS:

HSV-2 meningitis often presented as meningeal symptoms in younger women. Unfavorable outcome at discharge was common and was not associated with sex, age, immunocompromise, or CSF leukocyte count. Sequelae persisted beyond 6 months in one-tenth of patients.
Asunto(s)
Palabras clave

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Herpes Simple / Meningitis Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2022 Tipo del documento: Article País de afiliación: Dinamarca

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Herpes Simple / Meningitis Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2022 Tipo del documento: Article País de afiliación: Dinamarca