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Complete Guide to Herpes Meningitis
14 May 2023 |

Complete Guide to Herpes Meningitis

Herpes meningitis is a severe condition which takes place when herpes simplex virus or HSV infects protective membranes covering your brain and spinal cord called the meninges. This kind of meningitis is a form of viral meningitis and can occur through HSV-1. It is responsible for the oral herpes or HSV-2 associated with genital herpes. Though herpes meningitis is less common when compared to fungal or bacterial meningitis, it may be the reason for significant discomfort and complications, when not diagnosed and treated promptly. Read on to know “Is meningitis a type of STD?”

Importance of knowing the condition and its symptoms

Understanding the signs and symptoms of herpes meningitis is vital to get medical care on time and lessen possible complications. Early treatment can decrease the severity of the disease and prevent neurological damage for a long term. Besides, knowing the risk factors and transmission routes of herpes simplex virus may help in prevention and lessen the chances of developing herpes meningitis. Individuals may protect themselves and others by raising awareness about this condition and ensuring healthy and safer community.

Causes of herpes meningitis

Herpes meningitis commonly occurs due to herpes simplex virus (HSV) types 1 and 2 which are responsible for genital and oral herpes.

The virus can spread through contact with secretion or saliva from the mouth or genitals and through communication with the infected skin lesions.

Certain risk factors for developing herpes meningitis are – weakened immune system due to HIV/AIDS, taking immunosuppressant drugs or undergoing chemotherapy.

Though HSV-1 and HSV-2 can lead to meningitis, HSV-2 is more common than HSV-1 in this regard.

How you can diagnose herpes meningitis

  • Medical record and physical examination

Diagnosing herpes meningitis starts with a thorough assessment of medical history and physical examination of a person. The healthcare provider asks about the symptoms, recent diseases and probable exposure to herpes simplex virus. They will even check for the signs of meningitis such as – fever, neck stiffness and change in medical state.

  • Lumbar puncture or spinal tap

A lumbar puncture or spinal tap is a diagnostic method which helps to detect the presence of herpes meningitis. During this method, a needle gets inserted into the lower back for collecting the sample of cerebrospinal fluid or CSF which surrounds your brain and spinal cord. The accumulated fluid will be examined to detect any signs of infection such as elevated protein levels, increased white blood cell count and decreased glucose levels.

  • Polymerase chain reaction test for HSV DNA

A polymerase chain reaction or PCR test is done on the sample of cerebrospinal fluid during the lumbar puncture. This specific test can identify minute amounts of HSV DNA into the fluid which allow for thorough diagnosis of herpes meningitis. The PCR test may differentiate between HSV-1 and HSV-2 by providing valuable information to know about the most appropriate treatment plan for patient.

Symptoms associated with herpes meningitis

Mild cases can lead to flu-like symptoms and a person might suffer from constant headache with one or more of the following:

  • fever
  • lack of appetite
  • vomiting
  • stiff neck
  • lethargy
  • nausea
  • irritability
  • sleepiness or difficulty waking
  • irritability
  • sensitivity to light called photophobia

People who have mild cases of viral HM usually recover within 7 to 10 days. See a doctor right away in the case your condition worsens all of a sudden.

How to deal with the symptoms

Other than taking antiviral medications, the treatment for herpes meningitis usually involve managing the symptoms to ensure comfort and well-being of patients.

  1. Pain relievers: Taking over-the-counter medications such as acetaminophen or ibuprofen may alleviate fever and headache.
  2. Anti-inflammatory medications:Using non-steroidal and anti-inflammatory drugs such as ibuprofen can lessen inflammation and provide relief from fever and pain.
  3. Fluid intake and hydration: Having sufficient intake of fluid is necessary to maintain proper hydration and avoid further complications. Intravenous fluids can be given in bad cases or when the patient cannot drink adequately.

Complications with herpes meningitis

Long-term neurological problems

Though herpes meningitis is usually treated by taking antiviral medications, some patients may suffer from neurological concerns for a long time. These include – change in your personality, cognitive difficulties or memory problems. In rare cases, having severe infections may cause serious complications such as – vision problems, seizures or hearing loss.

Recurrent episodes of meningitis

Individuals who have herpes meningitis may suffer from repeated episodes of this condition. This can be very challenging to manage as each recurrence can probably cause further neurological damage. It is important for patients with herpes meningitis to work closely with the healthcare providers for detecting any signs of recurrence and initiate treatment promptly, when needed.

Encephalitis or brain inflammation

There are rare cases when herpes meningitis may progress further to encephalitis, which is more severe for inflammation of the brain. Herpes encephalitis can be life-threatening which requires immediate medical attention. Symptoms of encephalitis include – high fever, severe headache, seizures, altered mental condition or coma. With proper diagnosis and necessary treatment by taking antiviral medications, you can manage this serious complication.

How does herpes meningitis spread?

The viruses that may cause viral meningitis can spread from one person to the other through sneezes, coughs or through contact with surfaces which are contaminated with this virus. Herpes viruses can transmit through kissing or sexual contact. These viruses remain in the body of a person for life and triggers can be the reason for periodic active outbreaks.

Can herpes meningitis pass to your baby?

The virus may pass on from a person having an HSV infection to a baby at the time of childbirth. A baby who has contracted HSV will usually experience the symptoms by the end of their first week of life.

Common signs of HSV infection in babies are:

  • blisters
  • quick breathing
  • yellowing of your eyes and skin known as jaundice
  • blue coloration of the skin
  • labored or intermittent breathing
  • bleeding easily
  • irritability

Is meningitis a kind of STD? 

Meningitis is not a sexually transmitted disease or STD but an inflammation of protective membranes (meninges) which cover your brain and spinal cord. Different kinds of bacterial, fungal, parasitic and viral infections may cause it. But there are some viruses which can be the reason for meningitis like herpes simplex virus and can be transmitted sexually. In such cases, these viruses can cause meningitis though the condition is not categorised as a STD.

How you can prevent herpes meningitis

The most effective way to stay away from it is by taking the following steps:

  • do not kiss someone who has cold sores
  • wear condoms to decrease direct exposure to genital sores
  • restrict the number of sex partners to the ones who test negative for HSV
  • avoid sexual contact with a partner who has active outbreak of HSV
  • clean and disinfect surfaces that are contaminated with viruses
  • wash hands properly and thoroughly

How long will the treatment be for herpes meningitis?

HSV-2 meningitis is actually rare complication of HSV-2 genital herpes infection which affects women more than men. IV therapy should be considered till clinical improvement which is then followed by oral antiviral therapy to complete 10 days of the entire treatment. There will be longer treatment duration for complicated cases.

How serious is herpes meningitis?

Herpes meningoencephalitis is an infection of your brain covering (meninges) which take place due to herpes simplex virus. It is a medical emergency which requires treatment immediately.

Is it possible to cure herpes meningitis?

With proper treatment, most people having this disease begin to improve within one or two days and seem to recover completely in a month. But without treatment, serious complications can set in including untimely death. Even with treatment, some severe cases may have brain damage for a long time.

When you should see a doctor

The early treatment for herpes meningitis can give you the best possible result. It is advisable to visit a doctor when you or your child suffers from any of these symptoms:

  • fever
  • vomitting
  • nausea
  • persistant headache
  • neck stiffness
  • sleepiness or difficulty waking
  • sensitivity to light
  • trouble breathing
  • unusual bleeding

If the person experiencing any of these symptoms and has a past record of HSV infection, they should inform the doctor about it. Doing so can speed up diagnostic procedure which enables the person to get treatment soon.

Meningitis involves swelling of meninges which are membranes that encapsulate your spinal cord and brain. Most cases are mild and resolve completely without any medical treatment in a week. People who suffer from serious cases of herpes meningitis need to go to the hospital. Some cases progress further to become meningoencephalitis, which is severe neurological condition and requires immediate medical attention.

You may get tested at and know whether you are having any infection. Consult with our doctors by dialing 020 7183 0649 or walk in at the clinic to know more about your health condition.