HSV-2 reactivation following influenza A H3N2 Infection in an adolescent with transverse myelitis: A case report and literature review

Herpes simplex virus type 2 (HSV-2) reactivation following influenza infection is rare but clinically significant. Influenza-induced immunosuppression may trigger reactivation of latent herpesviruses. A 17-year-old male with transverse myelitis developed HSV-2 myelitis after influenza A (H3N2) infection, presenting with fever, cough, and acute quadriparesis requiring ventilation. Cerebrospinal fluid tested positive for HSV-2, while nasopharyngeal and oropharyngeal swabs tested positive for Influenza A (H3N2), and MRI showed extensive cervicothoracic gray matter involvement. Treatment with antivirals, corticosteroids, and immunoglobulin led to marked neurological recovery. Influenza-related immunosuppression can precipitate HSV-2 reactivation; early diagnosis and antiviral therapy are essential for favorable outcomes.