Viral meningitis
Viral meningitis | |
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Classification and external resources | |
Specialty | neurology |
ICD-10 | G0.2 |
ICD-9-CM | 321.2 |
eMedicine | article/1168529 |
MeSH | D008587 |
Viral meningitis is an inflammation of the meninges (the membranes covering the brain and spinal cord) caused by viral infection. It is also called aseptic meningitis or subsumed under lymphocytic choriomeningitis (LCM) due to its cerebrospinal fluid (CSF) test results. Based on clinical symptoms, viral meningitis cannot be differentiated from bacterial meningitis. Both appear as headache, fever, and neck stiffness but viral meningitis has no evidence of bacteria present in CSF. However, viral meningitis is less serious than bacterial meningitis. Therefore, CSF analysis is needed to identify the disease. In general, there are no medications to fight the virus that cause meningitis, so treatment is usually aimed at relieving the patient's symptoms by having a rest and fever-reducing medication.
Most cases are caused by enteroviruses (common stomach viruses).[1][2] However, there is evidence that other viruses can also cause viral meningitis. For instance, West Nile virus, mumps, measles, herpes simplex types I and II, varicella, and lymphocytic choriomeningitis (LCM) virus.[2][3]
In the United States from 1988–1999, about 36,000 new cases of viral meningitis occur each year.[4] This disease can occur in both children and adults depending on specific viruses and epidemic area. For example, an outbreak reported in Romania 1996, viral meningitis is more common among adults, as well as a 9-year Spanish study, it was more often seen in patients aged 15 years or older (66.1%; mean 30.2 yo).[5] While, patients aged younger than 15 (mean 5.9 yo) was seen 33.8% of all cases.[5] In contrast to a study in Finland 1966 and the outbreaks in Cyprus 1996, Gaza 1997, China 1998 and Taiwan 1998, the incidences of viral meningitis were more common among children.[6][7][8][9]
Causes
Causative organisms include:[10]
- Enteroviruses
- Enterovirus 71
- Echovirus
- Poliovirus (PV1, PV2, PV3)
- Coxsackie A virus (CAV); also causes Hand foot and mouth disease
- Herpesviridae (HHV)
- Herpes simplex virus type 1 (HSV-1 / HHV-1) or type 2 (HSV-2 / HHV-2); also cause cold sores or genital herpes
- Varicella zoster (VZV / HHV-3); also causes chickenpox and shingles (herpes zoster)
- Epstein–Barr virus (EBV / HHV-4); also causes infectious mononucleosis/"mono"
- Cytomegalovirus (CMV / HHV-5)
- Human Immunodeficiency Virus (HIV); causes AIDS
- La Crosse virus
- Lymphocytic choriomeningitis virus (LCMV)
- Measles
- Mumps
- St. Louis Encephalitis virus
- West Nile virus
Treatment
Herpes simplex virus, varicella zoster virus and cytomegalovirus have a specific antiviral therapy; most other viruses do not. For HSV the treatment of choice is acyclovir.[11]
References
- ↑ "Epidemiology". Alaska Department of Health and Social Services.
- 1 2 Logan, SA; MacMahon, E (Jan 5, 2008). "Viral meningitis.". BMJ (Clinical research ed.) 336 (7634): 36–40. doi:10.1136/bmj.39409.673657.ae. PMC 2174764. PMID 18174598.
- ↑ "Acute Communicable Disease Control". lacounty.gov.
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in Authors list (help) - ↑ Khetsuriani, N; Quiroz, ES; Holman, RC; Anderson, LJ (Nov–Dec 2003). "Viral meningitis-associated hospitalizations in the United States, 1988–1999.". Neuroepidemiology 22 (6): 345–52. doi:10.1159/000072924. PMID 14557685.
- 1 2 Jiménez Caballero, PE; Muñoz Escudero, F; Murcia Carretero, S; Verdú Pérez, A (Oct 2011). "Descriptive analysis of viral meningitis in a general hospital: differences in the characteristics between children and adults.". Neurologia (Barcelona, Spain) 26 (8): 468–73. doi:10.1016/j.nrleng.2010.12.004. PMID 21349608.
- ↑ Rantakallio, P; Leskinen, M; von Wendt, L (1986). "Incidence and prognosis of central nervous system infections in a birth cohort of 12,000 children.". Scandinavian journal of infectious diseases 18 (4): 287–94. doi:10.3109/00365548609032339. PMID 3764348.
- ↑ "1998—Enterovirus Outbreak in Taiwan, China—update no. 2". WHO.
- ↑ "1997—Viral meningitis in Gaza". WHO.
- ↑ "1996—Viral meningitis in Cyprus". WHO.
- ↑ Viral Meningitis at eMedicine
- ↑ Tyler KL (June 2004). "Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's". Herpes 11 (Suppl 2): 57A–64A. PMID 15319091.
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