Prophylaxis for close contacts of HSV meningitis?

• A. Acyclovir prophylaxis
• B. IV antibiotics
• C. None
• D. Steroids

Answer: (C)

Prophylaxis for close contacts of HSV meningitis is not indicated. HSV meningitis typically results from reactivation of latent virus in the patient, and contagiousness is mainly tied to active mucocutaneous lesions or viral shedding in those lesions. Providing antiviral prophylaxis to contacts has not shown a proven benefit and is not recommended. Management centers on treating the patient with appropriate antiviral therapy if needed, and advising contacts to avoid exposure to active lesions and maintain good hygiene. IV antibiotics and steroids do not play a role in preventing HSV meningitis in contacts.