Different Patterns of Neurologic Involvement with Herpes Simplex Virus Types 1 and 2: Isolation of Herpes Simplex Virus Type 2 from the Duffy Coat of Two Adults with Meningitis

Abstract

Six patients with herpes simplex virus (HSV) infection due to either HSV type 1 or type 2, and who had various neurologic syndromes, myelitis, encephalitis, or meningitis, were studied. Results of HSV typing of 81 isolates from spinal fluid, spinal cord, or brain and information from the literature led to proposal of a scheme that unifies concepts of the neurologic syndromes due to HSV and the pathogenetic pathways. (hematogenous or neurogenic) of viral infection of the nervous system in man. The varieties of neurologic manifestations and modes of viral dissemination appear to be greatly influenced by (1) condition of the host, (2) the frequency of a particular HSV type in different age or socioeconomic groups (type 2 HSV is most common in newborns and promiscuous adolescents or adults, type 1 HSV affects children and older otherwise healthy individuals most frequently). Data are presented that suggest that, even if these factors are considered, there may be a difference in neurologic manifestations and pathways of transmission to the nervous system according to the HSV type. In view of the increasing recognition of HSV as a cause of neurologic disorders and the potential use of antiviral therapy, thorough study of any such patients with a variety of laboratory procedures is important. The first report of the recovery of HSV type 2 from peripheral-blood buffy coat of two patients with meningitis is also presented.