Meningitis, Viral

Christine M. Broszko, MD and James E. Hougas, III, MD, FAAFP Reviewed 06/2019

BASICS

DESCRIPTION

A clinical syndrome characterized by signs/symptoms of acute meningeal inflammation from a viral etiology
Viral meningitis (VM) is the most common cause of aseptic meningitis (no iden...

DIAGNOSIS

HISTORY

Predominant adult symptoms include acute onset (hours to days) of:

Fever (in 76–100% of patients)
Headache (prominent early symptom)
Photophobia
Myalgias
Nausea, vomiting
Malaise
- In infants...

TREATMENT

GENERAL MEASURES

Management includes supportive care (e.g., pain control, IV fluids) and low threshold for empiric antibiotics for BM.

MEDICATION

First Line

Analgesics (adult doses; titrate dos...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Primary care follow-up to ensure resolution

Patient Monitoring

Monitor for relapse or exacerbation of symptoms.
Monitor for neurologic/neuroendocrine complications:
- ...

REFERENCES

Viallon A, Desseigne N, Marjollet O, et al. Meningitis in adult patients with a negative direct cerebrospinal fluid examination: value of cytochemical markers for differential diagnosis. C...

ADDITIONAL READING

Drysdale SB, Kelly DF. Fifteen-minute consultation: enterovirus meningitis and encephalitis—when can we stop the antibiotics? Arch Dis Child Educ Pract Ed. 2017;102(2):66–71. ...

CODES

ICD10

A87.9 Viral meningitis, unspecified
A87.1 Adenoviral meningitis
A87.0 Enteroviral meningitis
B00.3 Herpesviral meningitis
A87.2 Lymphocytic choriomeningitis
A87.8 Other viral meningitis
B02.1 Zos...

CLINICAL PEARLS

VM cannot be reliably distinguished from BM based on clinical findings alone.
Potential cases of BM should be hospitalized for evaluation and treatment with broad-spectrum antibiotics u...

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