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Viral Meningitis
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Viral Meningitis

(Aseptic Meningitis)

En Español (Spanish Version)

Definition

Viral meningitis is inflammation of the meninges. The meninges is the membrane covering the brain and spinal cord. Viral meningitis is cause by a virus. It is usually much less serious than bacterial meningitis .

The Spinal Cord and Meninges

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© 2008 Nucleus Medical Art, Inc.

Causes

A number of viruses can cause viral meningitis. These include:

Most of these viruses are capable of causing encephalitis . This is an inflammation of the brain tissue and is a much more serious condition.

Viruses that cause meningitis can be spread in numerous ways:

  • Enteroviruses are spread:
    • Via direct contact with respiratory secretions of an infected person
    • Through feces
  • Other viruses (mumps, herpes, chickenpox) are spread though close personal contact or (in some cases) through the air.
  • Some viruses that cause encephalitis are spread by insects.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for viral meningitis include:

  • Conditions that weaken the immune system, such as HIV infection (which itself can lead to meningitis/encephalitis)
  • Immunosuppressive treatments
  • Crowded, unsanitary conditions
  • Season: summer and early fall

Symptoms

Classic symptoms of viral meningitis include:

  • High fever
  • Headache
  • Stiff, sore neck
  • Nausea
  • Vomiting
  • Sensitivity to bright lights
  • Sleepiness

In newborns and infants:

  • Inactivity
  • High fever (especially unexplained high fever)
  • Irritability
  • Vomiting
  • Feeding poorly or refusing to eat
  • Tautness or bulging of soft spots between skull bones
  • Difficulty awakening

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam with emphasis on the nervous system. An MRI or CT scan may be done to rule out other causes of the inflammation, such as a tumor.

To rule out bacterial meningitis, the following tests may be done:

  • Lumbar puncture (spinal tap)—removal of fluid from the lower spinal column to be tested for bacteria (bacterial cultures)
  • Other cultures—blood, urine, mucus, and/or pus from skin infections

Treatment

Treatment includes:

  • Rest and fluids
  • Nonsteroidal anti-inflammatory drugs
  • Aspirin
    • Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving a child aspirin.
  • If encephalitis is present, intravenous antiviral drugs and other medications may be given.
  • Antibiotics may sometimes be given for 2 to 3 days while waiting for bacterial cultures to be reported as “negative.”

Prevention

Prevention includes:

  • If you are in close contact with an infected person, wash your hands frequently.
  • If changing the diaper of an infected infant, wash hands immediately afterwards.
  • If you work in a childcare setting, regularly wash objects and surfaces handled by children with a diluted bleach solution.
  • If you've never had measles, mumps, rubella, and chickenpox, consider being vaccinated.
  • Some forms of viral meningitis are spread by mosquito bites. Follow public health recommendations for reducing mosquito populations near your home and use precautions to avoid being bitten by mosquitoes.

Avoiding viral meningitis is particularly important during pregnancy. If you are contemplating a pregnancy:

  • Be sure you are protected from common diseases including chickenpox.
  • Avoid all contact with rodents during pregnancy; lymphocytic choriomeningitis virus can be acquired from pet hamsters, mice, or other rodents. If you own a rodent, consider finding another home for it while you are pregnant.

RESOURCES:

Meningitis Foundation of America
http://www.musa.org

US Centers for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/index_e.html

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

The Merck Manual of Medical Information . 18th ed. Merck; 2006.

The Merck Manual of Medical Information . 17th ed. Simon and Schuster, Inc.; 2000.

National Center for Infectious Diseases website. Available at: http://www.cdc.gov/ncidod/ .

US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov .



Last reviewed January 2008 by David L. Horn, MD, FACP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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