Herpes Meningitis - Symptoms, Complications, and Preventive Strategies

What Is Herpes Meningitis?

Herpes viruses are very common and quite diverse. Among the eight herpes viruses that infect humans, the herpes simplex virus causes cold sores, chickenpox, and infectious mononucleosis. Rarely they may cause meningitis in an individual. Meningitis is the common term for inflammation of the protective outer layers of the brain and spinal cord. It is a very serious type of infection that may progress to life-threatening situations and even death of the individual. Those who survive may be left with symptoms of brain damage.

How Does Herpes Infection Cause Meningitis?

It occurs when the herpes virus invades the meninges, which are the tissues that cover and protect the brain and spinal cord. Usually, the variety of herpes viruses that cause cold sores, genital sores, and chickenpox hide in the nerve cells or neurons in one’s body. The herpes virus enters a latent phase inside the body where the virus hides in the cells. And it may become active later on and cause other diseases like painful rashes (shingles). Because herpes hides in the nervous system, rarely can it make its way into the brain too. The same virus reaches the brain's temporal lobe and causes the infection known as meningitis.

The meninges of the brain have three layers. The cerebrospinal fluid, which also protects the brain and spinal cord, floats between the meninges' layers and over the brain's surface. In people who are already ill or have low immunity due to other conditions (immunocompromised), the herpes simplex virus may spread to the lining of their brain. When the virus attacks this space, the immune system begins to fight off the infection, and the meninges become inflamed. This is how one gets meningitis.

What Are the Symptoms of Herpes Meningitis?

Meningitis symptoms progress fast, and the affected individual may get sick quickly. Both viral and bacterial meningitis have similar symptoms. One may suffer:

• Frequent fever and chills.

• Lethargy, confusion, irritability, and loss of mental alertness.

• Loss of consciousness.

• Headache and stiff neck.

• Nausea and frequent vomiting.

• Grow sensitive to lights.

• Difficulty walking and moving around.

• Trouble waking up from sleep and staying sleepy throughout the day.

• Loss of appetite.

• Sometimes develop herpetic lesions on the skin elsewhere in the body.

• Tendency to bleed uncontrollably.

• An affected baby may show difficulty breathing, bluish skin, blisters over the body, and irritability.

What Are the Complications of a Herpes Meningitis Infection?

If the meningeal infection spreads over to the brain, the symptoms may turn more aggressive. Such a condition is known as herpes meningoencephalitis. It leads to high-grade inflammation in and around the brain. As a result, there will be fluid collection and swelling in both the meninges and brain raising the pressure inside the head dangerously high. Excess fluid compresses the brain, spinal cord, and other structures inside the head and causes serious damage. If left untreated, the damage cannot be reversed, and the individual may develop seizures, fall into a state of coma, or die. Those who recover from this condition may have long-lasting debilitating disabilities both at a physical and intellectual level.

How Is Herpes Meningitis Diagnosed?

The doctor will review the medical history of the affected individual. One should communicate past herpes infections, type of lesions, and other symptoms they suffered, with the doctor. The doctor will listen to the current symptoms, and if they point to viral meningitis, they may order the following tests:

1. Laboratory tests to check the presence of the virus in fluid samples taken from the nose and throat (nasal swabs and throat swabs), blood samples, and stool samples.

2. Lumbar puncture or spinal tapping procedure, where the doctor inserts a needle into the lower back area of the spine to draw a sample of cerebrospinal fluid (CSF). This sample is studied in the lab for the presence of the virus and signs of progressing inflammation.

3. In individuals with severely progressed meningitis, imaging studies like magnetic resonance imaging (MRI) and computed tomography (CT) scans are conducted to look for signs of inflammation and brain damage.

What Is the Treatment for Herpes Meningitis?

Most people with mild meningitis may recover on their own within a few weeks. Those with severe and progressive symptoms of herpes meningitis require hospitalization and round-the-clock medical attention. The doctor may prescribe:

• High doses of antiviral drugs like Acyclovir through the veins (intravenously). It helps block the virus's ability to replicate inside the body. This gives the immune system an opportunity to recover.

• Acetaminophen or other nonsteroidal anti-inflammatory drugs for fever and headache.

• If meningitis progresses to herpes meningoencephalitis, the individual may need special measures to reduce the pressure inside the head. The aim of the treatment will be to stabilize the patient and prevent brain damage from the inflammation before it turns fatal. One may need continuous monitoring till the pressure inside the head gets regulated.

• The doctor tries to bring down the inflammation using medications like corticosteroids.

• Sometimes, an affected individual may also require anticonvulsive drugs to control seizures.

How Can One Prevent Getting Infected With the Herpes Virus?

The herpes virus spreads from one individual to another individual mainly through skin-to-skin contact. Inhaling the droplets from an infected person's coughs and sneezes also contracts the virus. Another route of viral spread is through kissing and sexual contact. An infected mother can transfer the virus to her newborn at birth. This is the common reason why newborn babies get herpes meningitis.

1. Maintaining routine hygiene techniques such as washing hands, coughing, and sneezing into one’s sleeve, elbow, or a paper napkin can avoid infection to a certain extent.

2. Regularly disinfect frequently touched surfaces like door handles and light switches.

3. One should also stay vigilant about the chances of infection from unhealthy sexual practices. The use of condoms and testing oneself for herpes infection before sexual contact can also help prevent herpes infections.

Conclusion:

Most individuals affected with herpes meningitis recover without other health issues. But rarely, one may suffer attention deficits and temporary memory loss. Young children under the age of five are more susceptible to herpes meningitis. And some of them were found to develop mild neurological problems later on. Once infected, the herpes virus can cause symptoms later on. Preventive measures are not always successful, but one can take good precautions to avoid getting infected. And in case one encounters the symptoms of herpes meningitis, do not hesitate to take immediate medical help.