Mollaret's meningitis and enterovirus infection

Abstract

Mollaret's meningitis is a rare form of meningitis characterised by recurrent episodes of aseptic lymphocytic meningitis in otherwise healthy individuals. These episodes are often mild and self-limiting, with symptom-free intervals and no long-term neurological sequelae. Herpes simplex virus infection is by far the most common infectious aetiology. We report a case of Mollaret's meningitis in an otherwise healthy 8-year-old girl who presented with three distinct episodes of aseptic meningitis and frequent headaches over a 2-year period. Polymerase chain reaction for enterovirus (EV) RNA in the cerebrospinal fluid (CSF) was positive during her first episode. Diff Quik stained CSF preparations were positive for Mollaret cells during her second and third episodes. This is the first reported case of Mollaret's meningitis from EV infection. Early identification of the condition can avoid extensive investigations during recurrent episodes.