Highlights
- •Viral meningitis is a common disorder.
- •Common causes include non-polio human enteroviruses, mumps, lymphocytic choriomeningitis virus, and herpes viruses.
- •Kernig's, Brudzinski and jolt accentuation of headache are of limited clinical bedside diagnostic value.
- •Lumbar puncture with detection of viral pathogens by nucleic acid sequence-based amplification have emerged as the new diagnostic gold standard.
- •Pathophysiology, differential diagnosis, and management of viral meningitis is reviewed.
Abstract
Viral meningitis is an inflammation of the meninges associated with acute onset of
meningeal symptoms and fever, pleocytosis of the cerebrospinal fluid, and no growth
on routine bacterial culture. It is sometimes associated with viral encephalitis and
meningoencephalitis. Viruses reach the central nervous system (CNS) hematogenously
or in a retrograde manner from nerve endings. The viral etiology varies according
to age and country. Molecular diagnostics technology has helped improve the rate of
pathogen detection reducing unnecessary antibiotic use and length of hospitalization.
Most of the viral infections detailed in this article have no specific treatment other
than supportive care. Many of the viruses discussed are preventable by vaccination
and proper skin protection against transmitting vectors.
Keywords
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Article info
Publication history
Published online: January 31, 2019
Accepted:
January 30,
2019
Received in revised form:
January 28,
2019
Received:
November 9,
2018
Identification
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© 2019 Elsevier B.V. All rights reserved.
