The viral meningitis in our environment is more common in males and in summer months. Viral meningitis is less severe and symptoms can resolve without treatment. It also describes the substantial longterm impact that viral meningitis has on. Viral meningitis is usually less serious than meningitis that is caused by bacteria or fungi. Incidence, aetiology, and sequelae of viral meningitis in uk. Sciencedirect is a registered trademark of elsevier. Table 1 lists the causes of viral meningitis by frequency. Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant burden of disease in adults, with a mortality of up to 30%. The infectious diseases society of america idsa standards and practice guidelines committee collaborated with partner organizations to convene a panel of 10 experts on healthcareassociated ventriculitis and meningitis.
Viral meningitis can be differentiated from bacterial meningitis by the type of white blood cells identified in the csf. What complications occur during communityacquired bacterial meningitis, what ancillary investigations are warranted when complications occur and. Viral meningitis is an inflammation of the meninges associated with acute onset of meningeal symptoms and fever, pleocytosis of the. Incidence, aetiology, and sequelae of viral meningitis in. The most common causes of viral meningitis include enteroviruses, arthropodborne viruses especially west nile virus, herpes simplex virus2, lymphocytic choriomeningitis virus, and infection with hiv during the acute conversion period. Diagnosis is made by lumbar puncture see table 205, and care must be taken to exclude fungal or mycobacterial etiologies, because these may take days or weeks to grow in culture medium. Does the use of prophylactic treatment of household contacts decrease carriage or secondary cases. This risk is much lower in older children, whose mortality is. Hence, clinical syndromic surveillance must be complemented by. Recent clinical microbiology and infection articles elsevier. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. Communityacquired pneumonia in patients with bacterial meningitis.
Viral meningitis differs considerably from bacterial meningitis in the often subtle degree of inflammation present in tissue sections. During 2008, through nationwide surveillance, we collected. Pdf on feb 1, 2008, sarah a e logan and others published viral meningitis find, read and cite all the research you need on researchgate. In many cases, the specific virus that caused the meningitis is not. In general, meningitis caused by a virus is less serious than meningitis caused by bacteria. Can we use clinical characteristics to predict the absence. It results in inflammation of the meninges the membranes covering the brain and spinal cord. Impact of multiplex respiratory virus testing on antimicrobial consumption in adults in.
Untreated, bacterial meningitis is almost always fatal. However, aseptic meningitis may also present with sustained low csf glucose in cases of meningitis caused by ncc. Its caused by viruses, most often enteroviruses that live in the intestines. Bacterial meningitis and meningococcal septicaemia are important causes of. When meningitis is mild, drinking plenty of fluids, resting, and taking overthecounter otc drugs can help relieve fever and pain. Most cases in the united states are caused by nonpolio enteroviruses. Hsv1 typically causes encephalitis rather than meningitis. Enteroviruses evs are the leading cause of aseptic meningitis, which is the most frequent central nervous system infection worldwide. Viral names the causative agent, and the term meningitis implies lack of parenchymal and spinal cord involvement otherwise called encephalitis and myelitis, respectively. Bacterial meningitis is a more serious form of the disorder.
These viruses can be spread through food, water, or contaminated objects. With treatment, mortality risk of death from bacterial meningitis depends on the age of the person and the underlying cause. Most cases of viral meningitis respond to supportive treatment and resolve within 710 days. Epidemics of viral meningitis caused by echovirus 6 and 30. Viral meningitis is the most common and the least dangerous. The higher incidence rates from viral meningitis in males under the age of 15 are remarkably. Descriptive analysis of viral meningitis in a general hospital elsevier.
Apr 10, 2019 meningitis is the inflammation of the meninges of the brain and spinal cord as a result of either bacteria, viral or fungal infection. Viral meningitis is an infection of the meninges a thin lining covering the brain and spinal cord by any one of a number of different viruses. Meningitis is the inflammation of the meninges of the brain and spinal cord as a result of either bacteria, viral or fungal infection. Viral meningitis can result from a number of infections such as enteroviruses, herpes simplex. Viral meningitis is commonly referred to as aseptic meningitis because of characteristic aseptic csf. Those at greatest risk for this disease are infants between 6 and 12. It is sometimes associated with viral encephalitis and meningoencephalitis. Meningitis is confirmed when the leukocyte count in the csf exceeds 5 cells. The estimated annual incidence of viral meningitis was 273 per 100 000 and that of bacterial meningitis was 124 per 100health protection r 000. Most cases of viral meningitis are caused by enteroviruses. Acute bacterial meningitis is particularly serious and worsens rapidly. You get it when a virus enters the body through the nose or mouth and travels. Most cases of recurrent viral meningitis are caused by hsv2.
The clinical presentation and prodrome are similar in children and adults. Subacute meningitis and chronic meningitis usually progress slowly and gradually, but doctors may have difficulty determining what the cause is and thus what the treatment should be. Simultaneous pneumococcal and enterovirus meningitis. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. L with a neutrophilic predominance is highly suggestive of bacterial meningitis, 1 whereas lymphocytic predominance is more consistent with viral meningitis. Herpes simplex virus causes viral meningitis, which may recur.
Advances in meningitis treatment list of high impact. May 01, 2018 viral meningitis never can be distinguished from bacterial meningitis from a history and physical exam alone. About 90% of viral meningitis cases are due to common stomach viruses called enteroviruses, but other viruses can also cause viral meningitis. Correct immediate diagnosis and introduction of symptomatic and speci. Viral meningitis is a notifiable disease in england and wales, but many cases undoubtedly go unreported.
A person may transmit the disease from 3 days after heshe is infected until the bacteria is no longer present in discharges from the nose and mouth, which is generally about 10 days after developing symptoms. Patients diagnosed with meningitis syndrome may all exhibit similar symptoms i. Meningitis is an inflammation of the tissues that cover the brain and spinal cord. Early management of suspected bacterial meningitis and. Meningitis caused by enteroviruses occurs most often in babies and young children. Meningococcal meningitis is caused by the bacteria neisseria meningitidis, and. Introduction to meningitis brain, spinal cord, and nerve. Clinicians should be extremely wary of avoiding the lumbar puncture because of specious arguments regarding the likelihood of bacterial vs. Is vaccination indicated after communityacquired pneumococcal meningitis.
Viral meningitis serious disease viral aseptic meningitis is a serious, but not usually fatal with people with healthy immune systems. Meningitis can also be caused by bleeding into the meninges, cancer, an inflammatory response to certain types of chemotherapy or other chemical agents. Medications can cause aseptic meningitis simulating viral meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with. Viral meningitis can occur at any age but is most common in young children. Viral meningitis is the most common type of meningitis and can be caused by many different viruses. Meningitis acquired in a medical care setting, usually associated with neurosurgery or trauma. We calculated the incidence of viral meningitis using data from patients from the northwest. In korea, echovirus type 30 e30 and e6 have been associated with outbreaks and frequent meningitis.
Meningitis is an acute inflammation of meninges caused by bacterial, viral or fungal infection. Although some viral meningitis types can present with low csf glucose e. The prognosis depends mainly on the pathogen and host immunologic state. It is the largest clinical study of adults with viral meningitis reported to date and gives the first accurate incidence of viral meningitis, other causes, and those with no known cause. Epidemics of viral meningitis caused by echovirus 6 and 30 in. However, there are few reported cases of simultaneous. In the absence of a lumbar puncture, viral and bacterial meningitis cannot be differentiated with certainty, and all suspected cases should therefore be referred.
General measures may help relieve symptoms when meningitis is caused by conditions such as a viral infection or a reaction to a drug. Consistent, excess viral meningitis incidence rates in young males. Advances in meningitis treatment share this page antibiotics like fluoroquinolones are given in high doses by vein intravenously and additionally adjunctive antiinflammatory therapies eg, dexamethasone decrease inflammation and adjunctive therapeutic strategies, such as glycerol, paracetamol, and induction of hypothermia. Meningitis powerpoint 2009 warren hills regional school. As stated by many authors, mollarets meningitis should only be referred to recurrent aseptic meningitis with unknown aetiology after throughout studies including molecular tehcniques. Diagnosis, initial management, and prevention of meningitis.
While the term is not synonymous with viral meningitis, the two are often. We aimed to characterize the evs involved in an aseptic meningitis outbreak in korea in 2008. 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. Viral meningitis nonbacterial meningitis fact sheet. However, bacterial meningitis is a more severe form leading to numerous complications and early treatment is key. Classic features of viral meningitis are those of lymphocytic meningeal infiltrates fig. Viral meningitis, in contrast, tends to resolve spontaneously and is rarely fatal. Other sources include hematogenous spread of bacteria from distant infections, indwelling devices and drains, and vascular access catheters. Almost all of the cases occur as single, isolated events. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the cns is improving. Viral meningitis never can be distinguished from bacterial meningitis from a history and physical exam alone. What is the diagnostic accuracy of algorithms in the distinction between bacterial and viral meningitis.
Viral meningitis is common and often goes unreported. Viral meningitis is the most common form of meningitis and is caused by an infection with one of several types of viruses. A febrile illness with clinical signs and symptoms of meningeal irritation no associated neurologic dysfunction no evidence of bacterial pathogens in the cerebrospinal fluid in a patient who has not received prior antibiotics. Clinicians should be extremely wary of avoiding the lumbar puncture because of specious arguments regarding the likelihood of. Meningitis is usually a result of fungi, viruses, parasites, bacteria, or noninfectious inflammation. Viral infections are responsible for about 90% of the cases of acute meningitis redington and tyler 2002. Jul 17, 2018 viral meningitis is inflammation of the leptomeninges as a manifestation of central nervous system cns infection. In the largest reported study, a 1966 birth cohort of 12000 children in finland, the annual incidence of presumed viral meningitis was 219 per 00 in infants under. Viral meningitis is most commonly caused by the enteroviruses and is self. Other viral agents that can cause viral meningitis. In addition, culturing a sample of the fluid to determine whether bacteria are present is an effective way to distinguish between different causes of meningitis. Viral meningitis, also known as aseptic meningitis, is a type of meningitis due to a viral infection. All cases of viral meningitis are reportable to lac. Lumbar puncture and analysis of cerebrospinal fluid may be done primarily to exclude bacterial meningitis, but identification of the specific viral cause is itself beneficial.
The median length of hospital stay for patients with viral meningitis was 4 days iqr 37, increasing to 9 days 612 in those treated with antivirals. Viral meningitis is inflammation of the leptomeninges as a manifestation of central nervous system cns infection. Viral meningitis is an inflammation of the meninges associated with acute onset. You get it when a virus enters the body through the nose or mouth and travels to the brain. Kernigs, brudzinski and jolt accentuation of headache are of limited clinical bedside diagnostic value. Incidence, aetiology, and sequelae of viral meningitis in uk adults. Meningitis viral meningitis no bacteriana english version.