PDF(Pubmed)
Abstract：
Data on clinical features and outcomes of benign recurrent lymphocytic meningitis (BRLM) are limited.
This was a nationwide population-based cohort study of all adults hospitalized for BRLM associated with herpes simplex virus type 2 (HSV-2) at the departments of infectious diseases in Denmark from 2015 to 2020. Patients with single-episode HSV-2 meningitis were included for comparison.
Forty-seven patients with BRLM (mean annual incidence 1.2/1,000,000 adults) and 118 with single-episode HSV-2 meningitis were included. The progression risk from HSV-2 meningitis to BRLM was 22% (95% confidence interval [CI] 15%-30%). The proportion of patients with the triad of headache, neck stiffness and photophobia/hyperacusis was similar between BRLM and single-episode HSV-2 meningitis (16/43 [37%] vs. 46/103 [45%]; p = 0.41), whilst the median cerebrospinal fluid leukocyte count was lower in BRLM (221 cells vs. 398 cells; p = 0.02). Unfavourable functional outcomes (Glasgow Outcome Scale score of 1-4) were less frequent in BRLM at all post-discharge follow-up visits. During the study period, 10 (21%) patients with BRLM were hospitalized for an additional recurrence (annual rate 6%, 95% CI 3%-12%). The hazard ratio for an additional recurrence was 3.93 (95% CI 1.02-15.3) for patients with three or more previous episodes of meningitis.
Clinical features of BRLM were similar to those of single-episode HSV-2 meningitis, whilst post-discharge outcomes were more favourable. Patients with three or more previous episodes of meningitis had higher risk of an additional recurrence.
This was a nationwide population-based cohort study of all adults hospitalized for BRLM associated with herpes simplex virus type 2 (HSV-2) at the departments of infectious diseases in Denmark from 2015 to 2020. Patients with single-episode HSV-2 meningitis were included for comparison.
Forty-seven patients with BRLM (mean annual incidence 1.2/1,000,000 adults) and 118 with single-episode HSV-2 meningitis were included. The progression risk from HSV-2 meningitis to BRLM was 22% (95% confidence interval [CI] 15%-30%). The proportion of patients with the triad of headache, neck stiffness and photophobia/hyperacusis was similar between BRLM and single-episode HSV-2 meningitis (16/43 [37%] vs. 46/103 [45%]; p = 0.41), whilst the median cerebrospinal fluid leukocyte count was lower in BRLM (221 cells vs. 398 cells; p = 0.02). Unfavourable functional outcomes (Glasgow Outcome Scale score of 1-4) were less frequent in BRLM at all post-discharge follow-up visits. During the study period, 10 (21%) patients with BRLM were hospitalized for an additional recurrence (annual rate 6%, 95% CI 3%-12%). The hazard ratio for an additional recurrence was 3.93 (95% CI 1.02-15.3) for patients with three or more previous episodes of meningitis.
Clinical features of BRLM were similar to those of single-episode HSV-2 meningitis, whilst post-discharge outcomes were more favourable. Patients with three or more previous episodes of meningitis had higher risk of an additional recurrence.
摘要：
目的：良性复发性淋巴细胞性脑膜炎（BRLM）的临床特征和结局数据有限。
方法：这是一项全国性的以人群为基础的队列研究，研究对象是2015年至2020年在丹麦的传染病科因与2型单纯疱疹病毒（HSV-2）相关的BRLM住院的所有成年人。纳入单发HSV-2脑膜炎患者进行比较。
结果：纳入47例BRLM患者（成人年平均发病率1.2/1,000,000）和118例单发HSV-2脑膜炎。从HSV-2脑膜炎到BRLM的进展风险为22％（95％置信区间[CI]15％-30％）。头痛三联症患者的比例，BRLM和单发HSV-2型脑膜炎的颈部僵硬和畏光/过度紧张相似(16/43[37%]vs.46/103[45%]；p=0.41)，而BRLM的脑脊液白细胞计数中位数较低(221细胞vs.398个细胞；p=0.02）。在所有出院后随访中，BRLM的不利功能结局（格拉斯哥结局量表评分为1-4）较少出现。在学习期间,10例(21%)BRLM患者因额外复发而住院(年率6%，95%CI3%-12%）。对于先前三次或更多次脑膜炎发作的患者，额外复发的风险比为3.93（95％CI1.02-15.3）。
结论：BRLM的临床特征与单发HSV-2脑膜炎相似，而出院后结局更有利。先前三次或更多次脑膜炎发作的患者有更高的额外复发风险。
方法：这是一项全国性的以人群为基础的队列研究，研究对象是2015年至2020年在丹麦的传染病科因与2型单纯疱疹病毒（HSV-2）相关的BRLM住院的所有成年人。纳入单发HSV-2脑膜炎患者进行比较。
结果：纳入47例BRLM患者（成人年平均发病率1.2/1,000,000）和118例单发HSV-2脑膜炎。从HSV-2脑膜炎到BRLM的进展风险为22％（95％置信区间[CI]15％-30％）。头痛三联症患者的比例，BRLM和单发HSV-2型脑膜炎的颈部僵硬和畏光/过度紧张相似(16/43[37%]vs.46/103[45%]；p=0.41)，而BRLM的脑脊液白细胞计数中位数较低(221细胞vs.398个细胞；p=0.02）。在所有出院后随访中，BRLM的不利功能结局（格拉斯哥结局量表评分为1-4）较少出现。在学习期间,10例(21%)BRLM患者因额外复发而住院(年率6%，95%CI3%-12%）。对于先前三次或更多次脑膜炎发作的患者，额外复发的风险比为3.93（95％CI1.02-15.3）。
结论：BRLM的临床特征与单发HSV-2脑膜炎相似，而出院后结局更有利。先前三次或更多次脑膜炎发作的患者有更高的额外复发风险。
