Hemorrhagic and ischemic stroke secondary to herpes simplex virus type 2 meningitis and vasculopathy

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• 作者：Samuel B. Snider (1)
  Claire S. Jacobs (1)
  Patricia S. Scripko (1)
  Joshua P. Klein (1) (2)
  Jennifer L. Lyons (1)
  
• 关键词：HSV encephalitis ; CNS infection ; Infectious vasculitis ; Infectious stroke ; HSV ; 2
• 刊名：Journal of NeuroVirology
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：20
• 期：4
• 页码：419-422
• 全文大小：368 KB
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• 作者单位：Samuel B. Snider (1)
  Claire S. Jacobs (1)
  Patricia S. Scripko (1)
  Joshua P. Klein (1) (2)
  Jennifer L. Lyons (1)
  
  1. Departments of Neurology, Brigham and Women鈥檚 Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
  2. Departments of Radiology, Brigham and Women鈥檚 Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
  
• ISSN：1538-2443

文摘

Herpes simplex virus type 2 (HSV-2) meningitis dogmatically is benign and self-limited in the immune competent patient. However, we describe how left untreated HSV-2 meningitis can be complicated by vasculitis and both ischemic and hemorrhagic stroke. We report a 57-year-old woman with lymphocytic meningitis complicated by ischemic stroke and intracerebral hemorrhage in the setting of vasculopathy and HSV-2 DNA detected in CSF successfully treated with acyclovir and corticosteroids. Subsequent angiographic magnetic resonance imaging revealed improvement in the vasculopathy after treatment. This case demonstrates that HSV-2 meningitis may take a less benign course and further provides the first evidence of angiographic improvement in addition to clinical improvement after definitive treatment.