We are living in an age, where viral meningitis is rather straightforward – you really don’t need much diagnostics and therapy is not necessary, unless …
- it really is Lyme disease
- it recurs
- it is one of the few virus infections that will be treatable in the future (lots of upcoming antiviral agents)
Mollaret meningitis is a rare form of recurrent “aseptic” meningitis, usually due to HSV-2 infection, which can be detected by HSV PCR. But we usually don’t do an HSV PCR on all presumedly viral meningitides. We use a case of Mollaret’s do discuss the microbiologic aspects of HSV-2 infection, the workup of viral meningitis and finally the differential for recurring viral meningitis.