Recurrent herpes simplex virus type 2 meningitis in elderly persons.

OBJECTIVE To review the ages of patients with recurrent herpes simplex virus type 2 (HSV-2) meningitis. DESIGN Case report and literature review back to 1970. SETTING Referral Veterans Affairs hospital. RESULTS Our patient developed his first episode of recurrent HSV-2 meningitis at 78 years of age, 57 years after his only episode of genital herpes simplex infection. Of 223 patients in the literature with recurrent HSV-2 meningitis, 5% occurred in patients older than 60 years and 19% in patients older than 50 years. CONCLUSIONS Although recurrent meningitis due to HSV is primarily seen in young, sexually active adults, a surprising number of episodes of HSV meningitis can develop in older age. Meningitis due to HSV-2 should be in the differential diagnosis of aseptic meningitis in older patients.