Viral meningitis

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By John N Ratchford MD

Viral meningitis is also known as or subsumes Lymphocytic choriomeningitis. This article also discusses Aseptic meningitis associated with herpes simplex type 2 and Aseptic meningitis associated with parainfluenza virus. -ed.

Lymphocytic choriomeningitis. –ed.

About 36,000 cases of viral meningitis are estimated to occur in the United States each year. Enteroviruses cause most cases of viral meningitis. In this monograph, Dr. Ratchford of Johns Hopkins University reviews the basic diagnosis and management of viral meningitis. This updated monograph also has new information about human parecheovirus-3, a virus recently identified to occasionally cause neonatal meningitis and sepsis.

Key Points

  • The most common symptoms of viral meningitis are headache, fever, and neck stiffness.
  • Enteroviruses account for 85% to 95% of viral meningitis cases in the United States.
  • Viral meningitis and bacterial meningitis cannot be reliably differentiated based on clinical grounds, so CSF analysis is needed.
  • CSF will classically show a lymphocytic pleocytosis (usually <300 cells/mm3), a normal glucose, normal or mildly elevated protein, and a negative Gram stain and negative bacterial culture.