Viral meningitis tends to be less severe than an acute bacterial meningitis. Among the findings include headache, fever and stiff neck. The diagnosis requires CSF analysis. The treatment consists of supportive measures, acyclovir for suspected. Herpes simplex and antiretroviral drugs for suspected. HIV infection.

The term viral meningitis is sometimes used interchangeably with the term aseptic meningitis. However, aseptic meningitis usually refers to an acute meningitis, which was caused by something other than the bacteria, which typically cause an acute bacterial meningitis. Thus, an aseptic meningitis caused by viruses, non-infectious conditions (eg. As drugs, disease), fungi or, occasionally, other organisms (eg. As Crohn’s Lyme, syphilis) are caused.

Viral meningitis tends to be less severe than an acute bacterial meningitis. Among the findings include headache, fever and stiff neck. The diagnosis requires CSF analysis. The treatment consists of supportive measures, acyclovir for suspected. Herpes simplex and antiretroviral drugs for suspected. HIV infection. The term viral meningitis is sometimes used interchangeably with the term aseptic meningitis. However, aseptic meningitis usually refers to an acute meningitis, which was caused by something other than the bacteria, which typically cause an acute bacterial meningitis. Thus, an aseptic meningitis caused by viruses, non-infectious conditions (eg. As drugs, disease), fungi or, occasionally, other organisms (eg. As Crohn’s Lyme, syphilis) are caused. However causes Viral meningitis is usually formed by hematogenous spread, one by herpes simplex virus type 2 (HSV-2) caused meningitis may also result from the reactivation of latent infection. Most common cause of viral meningitis are enteroviruses For many viruses that cause meningitis (other than for bacteria that cause acute bacterial meningitis), there is a seasonal incidence (see Table: Common causes of viral meningitis). Common causes of viral meningitis virus transmission mechanism Seasonal incidence enteroviruses (eg., Coxsackie virus, echo virus) spread through feces or oral (eg., By contaminated food, in swimming pools) summer to early fall Sometimes all year sporadic cases * Herpes simplex virus, usually type 2 Close contact with a person spread the virus active – V aricella zoster virus Inhalation of respiratory droplets or by contact with an infected person No Western horse virus † Venezuelan horse virus † mosquito summer to early autumn West Nile virus St. Louis virus mosquito summer to early autumn California encephalitis virus laser Crosse virus mosquito summer to early fall Colorado tick fever virus (unusual) ticks Late spring to early summer lymphocytic choriomeningitis virus through the air transfer ‡ autumn to winter HIV-1 HIV-2 contact with body fluids of an infected person -§ * A herpes simplex type 2 meningitis can be used as occur isolated single event or recur (s. below). † Western and Venezuelan horse virus have been associated with meningitis, there were, however, reported in recent years in the US no cases. (Editor’s note: So far no reports in Germany.) ‡ The lymphatic choriomeningitis with exposure to infected wild mice (the natural host for the virus) associated and most often in the fall or winter, when the mice rather in the houses move. Infection can also occur throughout the year, where exposure to infected hamsters that are kept as pets, is the cause. § Meningitis due to HIV usually begins early in the course of systemic infection-in the event of seroconversion. Symptoms and discomfort begins Viral meningitis as an acute bacterial meningitis, usually with symptoms that suggest a viral infection (eg., Fever, myalgia, gastrointestinal or respiratory symptoms), followed by symptoms and signs of meningitis (headache, fever, neck stiffness). The manifestations are more similar to those of bacterial meningitis, but they are usually less violent (z. B. is the neck stiffness may be less pronounced). However, the findings are sometimes severe enough to suggest an acute bacterial meningitis. Diagnostic CSF analysis (cell count, protein, glucose) (Editor’s note: In Germany: instead of glucose lactate determination in CSF) PCR from cerebrospinal fluid and sometimes IgM Sometimes PCR and / or culture of blood, throat swab, nasopharyngeal secretions or the chair diagnosis of viral meningitis based on the analysis of cerebrospinal fluid, which was collected by lumbar puncture (after neuroradiological imaging in V. a. increased intracranial pressure or mass). Typically, however, the protein level is increased slightly less than the acute bacterial meningitis (e.g., <150 mg / dl.); However, the protein levels in West Nile virus meningitis can be very high. The glucose levels are usually normal or only slightly lower than normal. Other findings include a pleocytosis with a predominance of lymphocytes. Nevertheless, bacterial meningitis can be ruled out with any findings combination of cells, protein and glucose in the CSF. A CSF virus culture is insensitive and is not routinely performed. Using the PCR can be detected (enteroviruses and herpes simplex virus, herpes zoster, West Nile virus), some viruses in the CSF. The determination of IgM in the cerebrospinal fluid is more sensitive than the PCR in diagnosis with V. a. West Nile virus or other arbovirus. Virusserologische tests, PCR, or culture of samples taken from other areas (eg., Blood, throat swab, nasopharyngeal secretions, stool) may contribute to the identification of the causative virus. Tips and risks if patients appear seriously ill, they should be treated so long for acute bacterial meningitis until it is excluded, even if it is believed the cause was viral. Treatment Supportive care acyclovir (at V. a. Herpes simplex or herpes zoster) and antiretroviral drugs (for HIV infection) If patients appear seriously ill and acute bacterial is considered possible (even if a viral meningitis is assumed) is immediately (without waiting for the test results) to initiate treatment with appropriate antibiotics and corticosteroids and to the exclusion of bacterial meningitis (ie, the liquor is demonstrably sterile) continue. Viral meningitis usually lies down spontaneously after weeks or sometimes months (z. B. with West Nile virus meningitis or lymphocytic choriomeningitis). Treatment is mainly supportive. Acyclovir is effective in the treatment of herpes simplex meningitis and can be used to treat herpes zoster meningitis. In V. a. one of these viruses or when a herpes simplex encephalitis is suspected, most clinicians start with an empirical acyclovir treatment, and if the PCR regard. This virus negative, the drug is discontinued. Pleconaril is only moderately effective in meningitis due to enteroviruses and is not available for routine clinical application. Patients with HIV meningitis be treated with antiretroviral drugs. Conclusion A viral meningitis begins with typical symptoms of a viral disease with subsequent headache, fever and stiff neck, but it is rarely as severe as acute bacterial meningitis. Enteroviruses are the most common cause, usually in the summer or early fall. Based on the CSF findings (usually lymphocytic pleocytosis, near normal glucose and slightly elevated protein levels) can not be excluded an acute bacterial meningitis. (Note / Editor's correction: [..] can be excluded acute bacterial meningitis.) Treating them until this diagnosis was excluded patients in acute bacterial meningitis. Treatment is supportive primarily; simplex patients with herpes or herpes zoster meningitis can be treated with acyclovir.

Health Life Media Team

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