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Meningitis, Viral

Zoe J. Foster, MD, FAAFP and Jeffrey Wisinski, D.O. Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A clinical syndrome characterized by fever with signs/symptoms of acute meningeal inflammation (including but not limited to headache, photophobia, neck stiffness, and/or nausea/vomi...

DIAGNOSIS

HISTORY

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

    • Fever (incidence varies by virus; 65-83% in enterovirus, 54-98% in mumps, 6-52% in HSV) [C]

    • Headache (pro...

TREATMENT

GENERAL MEASURES

Management includes supportive care (e.g., pain control, IV fluids) and low threshold for empiric antibiotics for BM pending laboratory results (2)[C]. 

MEDICATION

First Line

  • A...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Close follow-up to ensure resolution of all symptoms.

    • A small portion of adult patients suffer from ongoing neuropsychological morbidities (cognitive ...

REFERENCES

1
Shahan B, Choi EY, Nieves G. Cerebrospinal Fluid Analysis. Am Fam Physician. 2021;103(7):422-428.
2
Kohil A, Jemmieh S, Smatti MK, et al. Viral meningitis: an overview. Arch Virol. 2021;166...

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.

  • Hospitalize potential meningitis cases for evaluation and treatment with broad-spectrum antibiotics until B...

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