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Abstract
Several patients with herpes simplex encephalitis developed a prolonged humoral immune
reaction within the central nervous system, which was evaluated by the measurement
of locally synthesized immunoglobulin fractions in cerebrospinal fluid. Such phasic
immune responses seem to occur predominantly in CNS infections with herpes and myxo/paramyxo
viruses. In many cases the B-cell response follows a primary neutrophilic and a secondary
mononuclear phase. Most benign viral encephalomeningitis cases lack this type of strong
local B-cell activity. This is also true in most cases of bacterial meningitis, that
recover after a strong neutrophilic attack and a minor mononuclear reaction. The initial
phase of a purulent meningitis is characterized by a complete breakdown of the blood-CSF
barrier. This occurs also in some cases of “apurulent bacterial meningitis”, that
are characterized by very low CSF-cell counts in spite of a totally broken barrier.
The “compartmental leucopenia” is interpreted as an imbalance between the supply from
the blood and an intense phagocytic consumption within the CSF space. The influence
of the hydrodynamic size of viruses on the mode of entry into the central nervous
system and on the dynamics of the inflammatory reactions is discussed.
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Article info
Publication history
Accepted:
February 13,
1980
Received in revised form:
February 12,
1980
Received:
November 26,
1979
Identification
Copyright
© 1980 Published by Elsevier Inc.