Viral Meningitis

[baliga]

Hi there............My daughter has been in the hospital with serious viral meningitis for the last 6 days and will be there for another 6 days.   They have determined that the herpes virus is responsible for the meningitis.

Question:  Can the herpes simplex cause the viral meningitis even if she does not have the genital herpes? Can just being in contact with someone or touching something have the virus enter her blood.  She was tested negative for the virus a couple months ago.

She was quite sick and had to be given morphine, anit-viral and steroids.
Baliga

[Terri Warren, RN, Adult Nurse Practitioner]

Wow, that is a very very scary event for you and your family.  I'm so grateful that you wrote and updated all of us, our good thoughts and prayers are all with you as you go through this difficult time.

Terri

[neofalsegod]

Ok so I am going to write out the whole story of what happened with Mariela so everyone knows and I don't have to tell the story over and over.

Sunday afternoon Mariela told me that she had a headache and I didn't think much of it. Later that evening she said her head hurt really bad. I gave her some tylenol and told her to go to bed. In the morning Makayla came and woke me up saying that Mariela was crying because her head hurt. I gave her some more tylenol and she laid on the couch all day. I gave her tylenol 2 more times throughout the day/evening. Before bed she was really crying so I asked her if she wanted me to take her to the hospital. She said yes, so off we went at midnight to the hospital. When we got there we signed in and were told that there were 16 people in front of us and there would be about a 4 hour wait to be seen. So her and I discussed if we should stay or not. We decided to go home and go to bed and go to her dr first thing in the morning so we didn't catch something waiting there in the waiting room. Tues morn came and she still has a headache. We went to see her dr and they looked at her and couldn't see anything wrong except maybe some congestion so they sprayed some nasal spray up her nose and told me to give her tylenol/motrin every 3 hours. She went all day Tues after appt feeling fine. She played abd goofed off like she always does. Then again about 10pm she started saying her head hurt again. So I gave her some motrin and she went to sleep. At 4am she woke me up crying that her head hurt again. She also started vomiting a little bit. I called the dr because they said if the headache actually woke her up from sleep then I needed to call. Dr said for me to take her to the ER so they could do more testing like a CT to make sure nothing else was going on. We got to hospital about 530am (not one person in waiting room this time!!) First they tested her for strep and flu. When both of those came back negative they did blood work. When everything was normal with that they ordered a CT. After the results from that showed nothing was wrong he said the only other thing he could think to check would be to do a spinal tap to check for meningitis. I did not really want to do this because I knew it would be very painful for her. The dr said since she was little they would put her
to sleep in order to do the procedure so I agreed. At noon on Wed they did the spinal tap. At 2pm he came in and said that the spinal tap showed she does have meningitis. He went on to say that he was pretty sure that it was the viral kind not the bacterial kind because she would be MUCH sicker if it was the bacterial kind. So they gave her morphine for the pain and Zofran for the nausea and went ahead and admitted her so she could be monitored. All night she was in excruciating pain. It honestly seemed like the morphine was not working. She was also vomiting from being in so much pain. On Thursday around 130pm I got her out of bed to try to get her to go to the bathroom. The nurse was getting worried because she had not gone since the night before. When I got her out and took her into the bathroom she seemed really out of it. She kept playing with her gown and pulling at her IV. When she was sitting on the toilet she just looked at me and seemed very confused. I asked her "mariela, do you know who I am?" She shook her head no. I. Pointed to the baby and Michael and asked if she knew them and she shook her head no. Then I asked her her name and she couldn't say it. So the nurse said that she was going to call the dr because something was wrong. The dr came in and had some blood work done and secided to put a catheter in her. She said it was possible that the morphine was backing up in her system and causing her to act this way. They finally got the catheter in after a LOT of fighting (and me laying on her and 2 other nurses holding down her legs) and nothing really came out. Then she really got worried and decided to have her transferred to a different hospital where she could be better monitored. In the midst of getting ready to transport her the blood work came back showing that her sodium levels dropped dangerously low. So they started her on sodium IV. The ambulance came and I rode with her over to Central Dupage hospital. When we got here there were 2 drs and 6 nurses running around her trying to get her stable and get her up to CT. What was discovered was that her brain was swelling and the combination of the swelling and the low sodium was causing all sorts of new problems. It was causing her brain to tell her kidneys not to release urine and the swelling was causing the brain to be squished and caused the confusion. They put her on a breathing machine with a tube down her throat to help her breathe. They also put in a central line and an arterial port. One in each groin. They kept her sedated and on antibiotics until they could see major improvement. But my little sweet petite girl was fighting the sedative and would sit up in bed and it would take anywhere from 3 to 5 nurses to hold her down! On Sat morning they did another CT and decided to take her off the ventilator. She is doing pretty good now. She is able to talk and knows what is going on around her. She is still in a lot of pain! She still has the catheter in and the central line. We will see what happens tomorrow and how things are progressing. I am not sure how much longer she will be here. My guess is at least another 2 days. Could be longer it depends on how her body heals.

I want to thank all of you for your prayers and support! You all are the best!  My wife wrote this a couple days ago they are wondering if she had herpes for awhile, found to be negative for that. Mariela currently has a fever of 103. She is 8 years old. concerned father - Michael Vincent

[Terri Warren, RN, Adult Nurse Practitioner]

I suggest you ask an infectious disease doctor if you can get viral meningitis from HSV 1 as well as HSV 2.  This is also a nice medscape link that discusses viral meningitis and the herpes virus family.  It might be helpful reading for you.

If they isolated HSV 2 from her spinal fluid, then, yes, she likely has genital herpes.  But if they just isolated herpes virus and didn't distinguish type, it could be either.  I don't have that information - perhaps you do.

http://emedicine.medscape.com/article/1168529-overview
Best to you and your daughter, I hope she feels better very soon.

Terri

[baliga]

Hi Terri.........Thank you for your response.  It seems there is not a way for me to respond to your question.  My daughter is 29 years of age.  There appears to be some conflict with your answer and the information on the internet.  You indicate that you can contract viral meningitis from both HSV1 and HSV2.  The research on the internet says you cannot contract viral meningitis from HSV1.  So a bit confused.  

If she does not have genital herpes than how did it get into her system to be responsible for the viral meningitis?

Baliga

[Terri Warren, RN, Adult Nurse Practitioner]

I'm so sorry that your daughter has been ill and in the hospital, that must be very scary for you.  I'm a mom too, and know you must be really worried.  Herpes simplex virus types 1 and 2  can cause viral meningitis - that is, both genital and oral herpes (cold sores) can be associated with viral meningitis.  In fact, many people with new herpes infection get what's called an aseptic viral meningitis, severe headache, light sensitivity, that kind of thing, but it almost always resolves without a problem.  It sounds like your daughter is sicker than that, however.  But she should still recover well, and no, it isn't necessarily associated with genital herpes.  It could well be associated with oral herpes infection.  How old is your daughter?

Terri