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May 1980

Hypoglycorrhachia in Herpes Simplex Type 2 Meningitis

Arch Neurol. 1980;37(5):317. doi:10.1001/archneur.1980.00500540095019

Hypoglycorrhachia has been previously reported in mumps meningoencephalitis1 and lymphocytic choriomeningitis.2 The occurrence of significant hypoglycorrhachia in herpes simplex type 2 meningitis has not been previously reported,3 although Craig and Nahmias4 described one patient with a CSF glucose level of 41 mg/dL with a concomitant serum glucose level of 75 mg/dL. I report a case of aseptic meningitis associated with clinical and serologic evidence of a herpes simplex type 2 infection with associated hypoglycorrhachia.

REPORT OF A CASE  A previously healthy 28-year-old woman reported to her gynecologist on Oct 28, 1978, with a four-day history of increasing vulvar discomfort and tenderness in the left inguinal region. A 0.2-cm, tender inguinal lymph node on the left and a small superficial ulcer on the left labia were noted. This was considered typical herpes progenitalis. The patient soon experienced bitemporal throbbing headaches, lower lumbar soreness, diffuse myalgia, nausea, vomiting