Aseptic Meningitis by Echovirus Associated With Herpes Progenitalis

To the Editor.—  With regard to the article "Hypoglycorrhachia in Herpes Simplex Type 2 Meningitis" (Archives 1980;37:317) by Dr Brenton, I wish to make some observations.I and my colleagues have reported¹ a case of aseptic meningitis in a 29-year-old woman. A week before the appearance of meningeal symptoms, she had had a herpes progenitalis (herpes simplex virus, type 2 [HSV-2]) infection with histological confirmation. Type 13 echovirus was isolated from the CSF.Based on these facts and after reviewing the literature,^2-6 we concluded that the genital herpetic lesions would be a concomitant process in other viral meningeal infections in the same way that the HSV-1 orolabial lesions seem to be concomitant with multiple infections.The serologic titers of HSV-2 only have a correlation with a genital lesion, and the definite diagnosis of HSV-2 aseptic meningitis requires an HSV-2 isolation in CSF.