Herpes simplex virus type 2 meningitis as a manifestation of Good's syndrome

J Neurovirol. 2020 Jun;26(3):429-432. doi: 10.1007/s13365-019-00819-x. Epub 2019 Dec 19.

Abstract

Good's syndrome is a primary immunodeficiency phenocopy characterized for thymoma and immunodeficiency. The most frequent clinical presentation is recurrent or opportunistic infections, hematological alterations, and chronic diarrhea. We treated a 66-year-old man who consulted for 5 days of headache and diplopia with right sixth cranial nerve palsy at examination. Patient reported chronic diarrhea and prolonged febrile syndrome accompanied by weight loss of 23 kg in the last year. Exhaustive evaluation revealed Herpes simplex virus (HSV) type 2 meningitis, eosinophilic colitis, and type A thymoma. Severe antibody deficiency (hypogammaglobulinemia) associated with thymoma confirmed the diagnosis of Good's syndrome.

Keywords: Good’s syndrome; Herpes simplex virus type (HSV) 2; Hypogammaglobulinemia; Mollaret meningitis; Primary immunodeficiency; Thymoma.

Publication types

  • Case Reports

MeSH terms

  • Agammaglobulinemia / diagnosis
  • Agammaglobulinemia / immunology
  • Agammaglobulinemia / pathology*
  • Agammaglobulinemia / virology
  • Aged
  • Colitis / diagnosis
  • Colitis / immunology
  • Colitis / pathology*
  • Colitis / virology
  • Cranial Nerve Diseases / diagnosis
  • Cranial Nerve Diseases / immunology
  • Cranial Nerve Diseases / pathology*
  • Cranial Nerve Diseases / virology
  • Diplopia / diagnosis
  • Diplopia / immunology
  • Diplopia / pathology
  • Diplopia / virology
  • Eosinophilia / diagnosis
  • Eosinophilia / immunology
  • Eosinophilia / pathology
  • Eosinophilia / virology
  • Headache / diagnosis
  • Headache / immunology
  • Headache / pathology
  • Headache / virology
  • Herpes Simplex / diagnosis
  • Herpes Simplex / immunology
  • Herpes Simplex / pathology*
  • Herpes Simplex / virology
  • Herpesvirus 2, Human / growth & development
  • Herpesvirus 2, Human / immunology
  • Herpesvirus 2, Human / pathogenicity*
  • Humans
  • Lymphocyte Count
  • Male
  • Meningitis, Viral / diagnosis
  • Meningitis, Viral / immunology
  • Meningitis, Viral / pathology*
  • Meningitis, Viral / virology
  • Neoplasms, Glandular and Epithelial / diagnosis
  • Neoplasms, Glandular and Epithelial / immunology
  • Neoplasms, Glandular and Epithelial / pathology*
  • Neoplasms, Glandular and Epithelial / virology
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / immunology
  • Thymus Neoplasms / pathology*
  • Thymus Neoplasms / virology

Supplementary concepts

  • Thymic epithelial tumor