Recurrent Viral Meningitis

    
      Re: Recurrent Viral Meningitis
    


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Posted by CCF Neuro MD on August 16, 1997 at 23:20:40:

In Reply to: Recurrent Viral Meningitis posted by Linda Malmberg on July 25, 1997 at 23:45:42:

: I have recently had my third episode of viral meningitis.  The first episode was 2 1/2 years ago and was the most severe involving encephalitis and a mild TIA episode.  2 out of the 3 episodes required hospitalization with 10 days treatment of IV Acyclovir and Rocephin.  I have had a total of 5 lumbar punctures, all have indicated elevated WBC ranging from 90 - 235 and elevated protein 110 - 129.  Predominant lymphocytes 84 - 95%.  All cultures of CSF and blood have been negative for either bacteria or virus, however, a PCR assay for Herpes Simplex has never been done.  My question is this.  What are the pros and cons of prophylactic use of oral acyclovir as a means to avoid or reduce the severity of subsequent episodes of viral meningitis?  My doctors at this point can only assume that the source of my recurrent meningitis is HSV and are reluctant to reccommend daily oral acyclovir as a preventive.  Are there any studies on the side effects of long-term acyclovir use?  Are there any theories on the factors that may precipitate an exacerbation of the virus?  I obviously would be interested in any information regarding how best to avoid or decrease the frequency of repeat episodes of viral  meningitis.  Thanks for any help.
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Dear Linda:
Herpes simplex virus 2, and less so, herpes simplex virus 1, are important causes of recurrent lymphocytic meningitis. There are numerous other causes of recurrent/chronic meningitis, however, that are in the differential diagnosis. These include other infections such as lyme disease, sarcoidosis, Bechet

[angiern2]

A related discussion, menangitisrecurrent was started.