27 July 2026
: Case report 
Recurrent Ischemic Strokes Caused by HSV-2–Associated Cerebral Vasculitis in Antisynthetase Syndrome
Rare disease
Christian M. Räz
BCDEF 1*, Benjamin Wagner DE 2, Özgür Yaldizli DE 2, David T. Winkler DEF 1, Alessandra Angelini DE 1, David Dashti BCDE 3, Sebastian Wirz DE 1, Mihaela Stegert DE 1,4, Eliška Potluková DEFG 1
DOI: 10.12659/AJCR.952736
Am J Case Rep 2026; 27:e952736
Table 1 Overview of the serial cerebrospinal fluid (CSF) analysis showing the delayed HSV-2 clearance.
| Analysis | Reference | Day 1 | Day 15 | Day 22 | Day 30 | Day 52 |
|---|---|---|---|---|---|---|
| Leukocytes ×10/L | <5 | 77 | 62 | 78 | 47 | 13 |
| Mononuclear cells ×10/L | 77 | 61 | 78 | 47 | 13 | |
| Polymorphonuclear cells ×10/L | 0 | 1 | 0 | 0 | 0 | |
| Lactate in CSF mmol/L | 1.1–1.9 | 3.9 | 3.62 | 2.58 | 2.58 | 1.93 |
| Protein in CSF mg/L | 150–500 | 1545 | 984 | 1136 | 625 | 437 |
| CSF/serum albumin ratio ×10 | <9.1 | – | 19 | 23.6 | 12.8 | – |
| BioFire PCR | Negative | HSV 2 | HSV 2 | HSV 2 | HSV 2 | – |
| HSV-2-PCR quantitative GEq/mL | – | 12800 | 2000 | 1500 | 200 |