Meningite recorrente de Mollaret: uma revisão / Mollaret's recurrent meningitis: an overview

A meningite recorrente linfocítica benigna ou meningite de Mollaret, inicialmente descrita pelo neurologista francês Pierre Mollaret em 1944, é uma condição relativamente rara, benigna mas incapacitante durante os seus períodos de agudização. Trata-se de quadro inflamatório meníngeo recorrente devido a reativação de infecção pelo herpes simples vírus, particularmente o herpesvirus do tipo 2 (HSV-2). Pode ser reconhecida a partir do seu quadro clínico de meningismo agudo, perfil liquórico linfocítico e identificação do genoma viral por PCR no líquor. Aciclovir e seus derivados podem ser utilizado no seu tratamento ou na sua profilaxia. Sua identificação é importante no sentido de se excluir outras causas de quadros meníngeos recorrentes.

Benign recurrent lymphocytic meningitis or Mollaret's meningitis (MM) was frst described by the French neurologist Pierre Mollaret in 1944. MM is a relatively rare, benign but disabling condition. MM is a recurrent meningeal inflammatory illness due to reactivation of herpes simplex virus infection, particularly herpesvirus type 2 (HSV-2). It can be recognized from its clinical picture of acute meningism, lymphocytic CSF profle and by the identifcation of the viral genome in the CSF by PCR. Acyclovir and its derivatives may be used for its treatment or prophylaxis. The identifcation of MM is important in order to exclude other causes of recurrent meningeal conditions.

Herpes Simplex Virus 2 Infection Rate and Necessity of Screening during Pregnancy: A Clinical and Seroepidemiologic Study

PURPOSE: This study determined the seroprevalence of herpes virus 2 in gravidas and the differences between herpes virus 2-infected and healthy gravidas. The need to screen gravidas for herpes virus 2 was also evaluated. MATERIALS AND METHODS: A retrospective analysis involving 500 gravidas who underwent herpes virus 2 serologic testing and delivery in our hospital between January 2009 and August 2010 was performed. All patients in the study group were classified as herpes simplex virus 2 (HSV2) positive, and all cases were analyzed with respect to the clinical course of the pregnancy, pregnancy outcome, obstetric complications, and neonatal outcomes. SPSS software (version 14.0) was used for statistical analysis. A chi-square test and Student's t-test were used for statistical analysis. RESULTS: In the current study, the herpes virus 2 seroprevalence rate in gravidas was 17%. There was no significant difference in the rates of preterm delivery, premature rupture of membranes, preterm labor, and intrauterine growth restriction between the herpes virus 2-infected gravidas and the healthy control group. The rates of spontaneous abortion and sexually transmitted disease were higher in the herpes virus 2 infection group than the healthy control group. CONCLUSION: After educating gravidas on genital herpes and, if gravidas thereafter consent to herpes virus 2 screening, the risk of neonatal herpes virus 2 infections can be reduced. In addition, examination of gravidas for sexually transmitted diseases would increase as would appropriate treatment.

study on the potential role of trichomonas vaginalis in transmission of hearpes simplex virus type ll

The present model was established for studying the ability of T. vaginalis to acquire herpes simplex virus type II [HSV]. Green monkey kidney cells [Vero cells] were infected with HCV and T. vaginalis was inoculated three days later. The progress of virus transmission was monitored by transmission electron microscopy [TEM]. Fragments of virus containing Vero cells were engulfed by the trichomonads and internalized in vacuoles, followed by resolution of the vacuole boundary. Viral particles aggregates were retained. Viable HSV was recovered from the trichomonads for five days. A study was conducted through cytopathological examination of 170 cervicovaginal smears The study revealed 25.8% having trichomoniasis, 2.9% HSV infection and 1.17% with combined infection; while HSV infections represented 4.5% in those having trichomoniasis. These results suggested the potential role of T. vaginalis in viral transmission to reduce this risk

Progression of intravaginal infection by herpes simplex-2 in genetically athymic mice

The purpose of this paper was to study the pathogenesis of wild-type Herpes simplex-2 (HSV-2) primary intravaginal (IVAG) infection in genetically athymic (nude) mice. Nude (nu/nu) N: NIH(S) and Balb/c mice, as well as their euthymic counterparts were IVAG infected with 5 x 10(5) pfu of HSV-2. The progression of the infection was followed by HSV-2 immunolabeling using the peroxidase-antiperoxidase technique in tissue sections of the whole body, electron microscopy, and viremia titration at two different timepoints. 70 per cent of athymic NIH mice, 30 per cent of euthymic NIH mice, and 80 per cent of both athymic and euthymic Balb/c mice developed acute vulvovaginitis and died between 8-10 days post-infection (pi). Viremia was not detected in either athymic or euthymic mice. HSV-2 replicated in the vulvovaginal, vesical and perianal epithelia, then progressed towards the central nervous system mainly along autonomic nerves and ganglia. HSV-2 antigens were not detected in liver, spleen, kidney, skin, heart, lung or bone marrow. The conclusion is that the T-cell immune response seems to limit the IVAG infection of NIH mice at the inoculation site, but is not involved in preventing HSV-2 dissemination through the blood.

Encefalitis neonatal por virus herpes tipo 2 en un paciente sin alteraciones en líquido cefalorraquídeo: informe de un caso y revisión de la literatura / Neonatal encephalitis for herpes virus type 2 in patient without alterations in cerebrospinal fluid: report of a case and review of the literature

Se presenta el caso de una paciente femenina de 25 días de edad que desarrolló un cuadro de encefalitis por herpes tipo 2. Esta niña tuvo el antecedente de que su madre presentó lesiones genitales causadas por virus herpes desde las 30 semanas de edad gestacional; el diagnóstico en la madre fue corroborado mediante serología positiva para este virus. A los 20 días de edad presenta fiebre, deterioro del sensorio y cuadro convulsivo. El análisis del líquido cefalorraquídeo fue normal, pero la serología (IgG) para herpes simple en este fluido fue determinante en el diagnóstico de encefalitis. Se realizó una revisión de estudios publicados al respecto, confirmando lo infrecuente de esta patología cuando la enfermedad es adquirida de una madre con infección recurrente por este agent viral en el período neonatal. Se discuten los aspectos epidemiológicos y clínicos de la enfermedad, haciendo énfasis en la transmisión perinatal y en la importancia de la historia clínica materna para la prevención de casos neonatales