{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:43:08Z","timestamp":1791502988729,"version":"4.3.4"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NextGenerationEU-MUR PNRR","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Mollaret\u2019s meningitis is a rare neurological disorder characterized by recurrent episodes of aseptic lymphocytic meningitis, often associated with herpes simplex virus 2 (HSV-2) infection. We report the case of a 39 y.o. Italian woman who experienced four episodes of aseptic lymphocytic meningitis between 2004 and 2023, diagnosed as Mollaret\u2019s meningitis. In each episode, the patient presented with fever, severe headache and photophobia. In two episodes cutaneous vesicles in the left gluteal area preceding meningitis symptoms were also reported. A diagnostic evaluation included a physical\u2013chemical analysis and a real-time PCR of the cerebrospinal fluid (CSF). The CSF presented pleocytosis with lymphocytic predominance and a positive HSV-2 load, with a peak of 1234 copies\/mL. The patient was treated successfully with acyclovir, and the symptoms resolved without neurological sequelae. This case highlights the importance of comprehensive diagnostic testing and vigilant monitoring to manage Mollaret\u2019s syndrome effectively.<\/jats:p>","DOI":"10.3390\/microorganisms12071363","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T04:23:43Z","timestamp":1719980623000},"page":"1363","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Mollaret\u2019s Meningitis due to Herpes Simplex Virus 2: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5994-4749","authenticated-orcid":false,"given":"Liliana","family":"Gabrielli","sequence":"first","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Banchini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8214-9057","authenticated-orcid":false,"given":"Evangelia","family":"Petrisli","sequence":"additional","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2596-2367","authenticated-orcid":false,"given":"Giulia","family":"Piccirilli","sequence":"additional","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Venturoli","sequence":"additional","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pavoni","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Cantiani","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Lanna","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5951-639X","authenticated-orcid":false,"given":"Caterina","family":"Campoli","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Montironi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Giannella","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences, Infectious Diseases Section, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-363X","authenticated-orcid":false,"given":"Tiziana","family":"Lazzarotto","sequence":"additional","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences, Section of Microbiology, University of Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"ref_1","first-page":"57","article-title":"La meningite endothelio-leucocytaire multirecurrent benigne. Syndrome nouveau ou maladie nouvelle. Documents clinique","volume":"76","author":"Mollaret","year":"1944","journal-title":"Rev. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/ana.410110104","article-title":"Isolation of herpes simplex virus type I in recurrent (Mollaret) meningitis","volume":"11","author":"Steel","year":"1982","journal-title":"Ann. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1128\/iai.40.1.103-112.1983","article-title":"Comparative neurovirulence of herpes simplex virus type 1 strains after peripheral or intracerebral inoculation of BALB\/c mice","volume":"40","author":"Dix","year":"1983","journal-title":"Infect. Immun."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1056\/NEJM199110103251507","article-title":"Herpes Simplex Virus Type 1 DNA in Cerebrospinal Fluid of a Patient with Mollaret\u2019s Meningitis","volume":"325","author":"Yamamoto","year":"1991","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1016\/j.clineuro.2012.02.015","article-title":"Mollaret Cells Detected in a Patient with Varicella-Zoster Virus Meningitis","volume":"114","author":"Ohmichi","year":"2012","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1001\/archneur.1987.00520230084023","article-title":"Mollaret\u2019s Meningitis Associated with Acute Epstein-Barr Virus Mononucleosis","volume":"44","author":"Graman","year":"1987","journal-title":"Arch. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1177\/0009922806295286","article-title":"Mollaret\u2019s Meningitis Due to Human Herpesvirus 6 in an Adolescent","volume":"45","author":"Capouya","year":"2006","journal-title":"Clin. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.cmrp.2016.03.005","article-title":"Mollaret\u2019s Meningitis and Enterovirus Infection","volume":"6","author":"Kumar","year":"2016","journal-title":"Curr. Med. Res. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/00005072-198011000-00004","article-title":"Mollaret\u2019s Recurrent Aseptic Meningitis: Relationship to Epidermoid Cysts. Light Microscopic and Ultrastructural Cytological Studies of the Cerebrospinal Fluid","volume":"39","author":"Becker","year":"1980","journal-title":"J. Neuropathol. Exp. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e16081","DOI":"10.1111\/ene.16081","article-title":"Benign Recurrent Lymphocytic Meningitis (Mollaret\u2019s Meningitis) in Denmark: A Nationwide Cohort Study","volume":"31","author":"Petersen","year":"2024","journal-title":"Eur. J. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1212\/WNL.12.11.745","article-title":"Mollaret\u2019s Meningitis: Differential Diagnosis and Diagnostic Pitfalls","volume":"12","author":"Bruyn","year":"1962","journal-title":"Neurology"},{"key":"ref_12","first-page":"e7026","article-title":"A Rare Case of Mollaret\u2019s Meningitis Complicated by Chronic Intractable Migraine and Papilledema: Case Report and Review of Literature","volume":"12","author":"Gadhiya","year":"2020","journal-title":"Cureus"},{"key":"ref_13","first-page":"e38559","article-title":"Mollaret\u2019s Syndrome: A Case Report","volume":"15","author":"Edi","year":"2023","journal-title":"Cureus"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1080\/08998280.2022.2108991","article-title":"Recurrent benign lymphocytic (Mollaret\u2019s) meningitis due to herpes simplex virus type 2","volume":"35","author":"Grinney","year":"2022","journal-title":"Bayl. Univ. Med. Cent. Proc."},{"key":"ref_15","first-page":"e15264","article-title":"Mollaret\u2019s Meningitis: A Rare Entity","volume":"13","author":"Sehgal","year":"2021","journal-title":"Cureus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"916","DOI":"10.31729\/jnma.6950","article-title":"Benign Recurrent Aseptic Meningitis (Mollaret\u2019s Meningitis) in an Elderly Male: A Case Report","volume":"59","author":"Chand","year":"2021","journal-title":"J. Nepal Med. Assoc."},{"key":"ref_17","first-page":"e407","article-title":"Neuro-Ophthalmic Manifestations of Mollaret Meningitis","volume":"41","author":"Park","year":"2021","journal-title":"J. Neuro-Ophthalmol. Off. J. N. Am. Neuro-Ophthalmol. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.4103\/0028-3886.299162","article-title":"Mollaret\u2019s Meningitis: CSF Cytology to the Rescue","volume":"68","author":"Menon","year":"2020","journal-title":"Neurol. India"},{"key":"ref_19","first-page":"e11623","article-title":"Recurrent Aseptic Meningitis From Herpes Simplex Virus-2: Mollaret\u2019s Meningitis in a 30-Year-Old Female","volume":"12","author":"Kirkland","year":"2020","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"eabc2691","DOI":"10.1126\/sciimmunol.abc2691","article-title":"Defects in LC3B2 and ATG4A Underlie HSV2 Meningitis and Reveal a Critical Role for Autophagy in Antiviral Defense in Humans","volume":"5","author":"Hait","year":"2020","journal-title":"Sci. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jns.2018.11.018","article-title":"Mollaret meningitis","volume":"396","author":"Wright","year":"2019","journal-title":"J. Neurol. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/1941874417754029","article-title":"Mollaret Cells in Recurrent Benign Lymphocytic Meningitis","volume":"9","author":"Gluck","year":"2019","journal-title":"Neurohospitalist"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.2169\/internalmedicine.1676-18","article-title":"Mollaret Meningitis with a High Level of Cytokines in the Cerebrospinal Fluid Successfully Treated by Indomethacin","volume":"58","author":"Kawabori","year":"2019","journal-title":"Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1002\/dc.23684","article-title":"Tracing the footprints: A case of chronic meningitis with unusual mononuclear cells in the cerebrospinal fluid","volume":"45","author":"Acosta","year":"2017","journal-title":"Diagn. Cytopathol."},{"key":"ref_25","first-page":"52","article-title":"Recurrent Transcortical Motor Aphasia-Another CNS Infectious Syndrome Associated with Herpes Virus Infection","volume":"8","author":"Govindarajan","year":"2016","journal-title":"J. Vasc. Interv. Neurol."},{"key":"ref_26","first-page":"31","article-title":"Herpes simplex virus type 2-associated recurrent aseptic (Mollaret\u2019s) meningitis in genitourinary medicine clinic: A case report","volume":"7","author":"Buhary","year":"2014","journal-title":"Int. Med. Case Rep. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/S1473-3099(14)70874-6","article-title":"Mollaret\u2019s meningitis","volume":"14","author":"Min","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/QCO.0000000000000922","article-title":"Viral meningitis and encephalitis: An update","volume":"36","author":"Gundamraj","year":"2023","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1128\/CVI.00333-10","article-title":"Increased Cell-Mediated Immune Responses in Patients with Recurrent Herpes Simplex Virus Type 2 Meningitis","volume":"18","author":"Schepis","year":"2011","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_30","first-page":"43","article-title":"Recurrent Benign Lymphocytic (Mollaret) Meningitis in Systemic Lupus Erythematosus","volume":"14","author":"Mikdashi","year":"2008","journal-title":"Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100558","DOI":"10.1016\/j.lanepe.2022.100558","article-title":"Epidemiology of herpes simplex virus type 2 in Europe: Systematic review, meta-analyses, and meta-regressions","volume":"25","author":"Alareeki","year":"2022","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1093\/cid\/cis031","article-title":"Long-Term Valacyclovir Suppressive Treatment After Herpes Simplex Virus Type 2 Meningitis: A Double-Blind, Randomized Controlled Trial","volume":"54","author":"Aurelius","year":"2012","journal-title":"Clin. Infect. Dis."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/7\/1363\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:09:28Z","timestamp":1760108968000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/7\/1363"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,3]]},"references-count":32,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["microorganisms12071363"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms12071363","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,3]]}}}