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Acute Viral Meningitis

Signs & Symptoms

 Photophobia
Ref: Uptodate [ Aseptic meningitis in adults] Harrison [ 1003] Cecil [ 855] Epocrates [ https://online.epocrates.com/diseases/54033/Viral-meningitis/History-Exam]
Neck stiffness Gr. Adult #enteroviral_meningitis
Ref: Epocrates [ https://online.epocrates.com/diseases/54033/Viral-meningitis/History-Exam]
Rash Gr. infants and children
Ref: Uptodate [ Viral meningitis: Clinical features and diagnosis in children]
Non-specific rash Gr. Infants #Human_parechovirus_meningitis
Ref: Uptodate [ Viral meningitis: Clinical features and diagnosis in children]

Physical Examination

 Mildly elevated opening pressure
Note: 100-350 mmH2O
Ref: Harrison [ 1003]
Maculopapular rash #echovirus_meningitis
Ref: Epocrates [ https://online.epocrates.com/diseases/54033/Viral-meningitis/History-Exam]
Cranial nerve VII palsies #HIV_meningitis
Ref: Uptodate [ Aseptic meningitis in adults] Harrison [ 1005]

Lab / Serology

 Enteroviruses
Ref: Uptodate [ Aseptic meningitis in adults Viral meningitis: Epidemiology, pathogenesis, and etiology in children] Harrison [ 1004]
Positive CSF RT-PCR #Enteroviral_meningitis
Ref: Harrison [ 1004]
Positive CSF NAAT #Enteroviral_meningitis
Ref: Uptodate [ Aseptic meningitis in adults]

Imagin Study

 brain parenchymal involvement (negative symptom)
Ref: Harrison [ 1003]
Neuroimaging abnormalities (negative symptom)
Ref: Harrison [ 1003]
Pulmonary infiltrates #LCMV_meningitis
Ref: Uptodate [ Aseptic meningitis in adults Viral meningitis: Epidemiology, pathogenesis, and etiology in children] Harrison [ 1005]

Complication

 Disseminated intravascular coagulation Gr. Neonates
Note: Particularly with HSV.
Ref: Uptodate [ Viral meningitis: Clinical features and diagnosis in children]
Necrotizing enterocolitis Gr. Neonates
Note: Particularly with HSV.
Ref: Uptodate [ Viral meningitis: Clinical features and diagnosis in children]
Myocarditis Gr. Neonates
Note: Particularly with HSV.
Ref: Uptodate [ Viral meningitis: Clinical features and diagnosis in children]

Risk Factors

 Male
Ref: Harrison [ 1005]
5 < age < 10
Ref: Uptodate [ Viral meningitis: Epidemiology, pathogenesis, and etiology in children]
Age < 1
Ref: Uptodate [ Viral meningitis: Epidemiology, pathogenesis, and etiology in children]

Cause

 Enteroviruses
Ref: Uptodate [ Aseptic meningitis in adults Viral meningitis: Epidemiology, pathogenesis, and etiology in children] Harrison [ 1004]
Human parechoviruses Gr. Infants
Ref: Uptodate [ Viral meningitis: Epidemiology, pathogenesis, and etiology in children]
Parechoviruses Gr. Infants
Ref: Nelson Textbook [ 2946] Nelson Essentials [ 342]

Other