> Details

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

Herpes Simplex Virus 2 Meningitis in Adults: A Prospective, Nationwide, Population-Based Cohort Study

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: Herpes Simplex Virus 2 Meningitis in Adults: A Prospective, Nationwide, Population-Based Cohort Study
  • Contributor: 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
  • imprint: Oxford University Press (OUP), 2022
  • Published in: Clinical Infectious Diseases
  • Language: English
  • DOI: 10.1093/cid/ciab1071
  • ISSN: 1058-4838; 1537-6591
  • Keywords: Infectious Diseases ; Microbiology (medical)
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Data on the clinical presentation are scarce and prognostic factors of herpes simplex virus type 2 (HSV-2) meningitis remain unknown.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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 &amp;gt;1000 × 10 × 6/L (0.78 [.33–1.84]).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec>
  • Access State: Open Access