Apr 03, 2018 viral meningitis is the most common form of meningitis. In contrast to aseptic viral meningitis, neuropsychiatric symptoms often predominate in encephalitis, for example, anomia, hallucinations, psychosis, personality changes,and agitation. Viral meningitis aseptic or nonbacterial meningitis what is viral meningitis. Although hiv is a rare cause of viral meningitis, it is important that adults with viral meningitis due. Your health care provider may recommend rest, drinking plenty of fluids and prescribe medications to control fever and pain. Rest, hydration, antipyretics, and pain or antiinflammatory medications may be given as needed. Acute encephalitis constitutes a neurological emergency and it is imperative that appropriate treatment. Treatment for viral meningitis is generally rest and pain relievers. Meningitis can occur in adults and children, even in infants, and can be caused by viruses, bacteria, fungi, or parasites.
Bacterial meningitis requires close monitoring in the hospital. Viral meningitis is the most common but the least severe type. Viral meningitis in its pure form has a very good prognosis and mortality rates are trending towards zero, but the prognosis is dependent on additional spread of the viral infection to the brain. The headache may be intense, especially at onset, and may require narcotics for pain relief. Dilemmas exist for emergency medicine and primarycare providers who need to accurately diagnose patients with bacterial meningitis and then rapidly administer antibiotics and adjunctive. Acute encephalitis constitutes a neurological emergency and it is imperative that appropriate treatment is started as soon. If meningitis is strongly suspected, antibiotics should be commenced within 1 hour of arrival. Jul 17, 2018 treatment for viral meningitis is mostly supportive. Most patients recover without treatment within seven to ten days. Viral meningitis is most common and the least serious. In general, there are no medications to fight the germs that cause viral meningitis, so treatment is usually aimed at easing the symptoms.
Because viral meningitis is caused by a virus, antibiotics are not used to treat it, and will not make you feel better. Viral meningitis aseptic or nonbacterial meningitis. Many patients with viral meningitis are hospitalized to exclude bacterial meningitis and other treatable diseases. Almost all patients with viral meningitis recover without any permanent damage, although full recovery may take weeks to months. When a virus infects the lining of the brain and spinal cord it is called viral meningitis. Meningococcal meningitis and covid19 coinfection bmj. Several types of viral meningitis cases are vaccinepreventable including those caused by vzv, mumps, influenza, and measles. Garlic can be very beneficial for those suffering from meningitis as the allicin and various. Bacterial coinfection in the ongoing pandemic of covid19 is associated with poor outcomes but remains little understood. With few exceptions, the clinical manifestations and symptoms associated with viral meningitis are similar for the different causative agents. Despite the existence of antibiotic therapies against acute bacterial meningitis, patients with the disease continue to suffer significant morbidity and mortality in both high and lowincome countries.
Features of viral and bacterial meningitis in children csf analysis in cns infections antiviral dosing for flu treatment in children etiology of aseptic meningitis management of suspected meningitis in children related topics. The pathogenesis of viral meningitis is not clearly defined, and more studies are needed to improve the health care of patients. Identification of resource use and associated costs for. Examples include cryptococcal, which is caused by a fungal infection, and. Recurrent benign lymphocytic meningitis also known as mollaret meningitis is a rare condition thought to be due to viral infection. Identification of resource use and associated costs for viral. Because the illness is caused by a virus, antibiotics are not useful for treatment and will not make the patient feel better. Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.
Cerebrospinal fluid bacterial pcr was positive for neisseria meningitidis. Severe viral meningitis may also be treated in hospital. Meningitis can be caused by an infection with several different viruses or. Good personal hygiene, especially hand washing and. The treatment will also include antibiotics if your meningitis is caused by a bacterial infection, and antivirals for some specific types of viral infections. This document has been downloaded from the whoemc web site. This includes rest, fluids, and feverreducing medicine. Most cases of viral meningitis are caused by enteroviruses. It can be caused by many different viruses, but the most common are the herpes simplex virus normally the same type of virus that causes genital herpes, the chickenpox or shingles virus also known as varicella zoster virus, and the enterovirus. Almost all patients recover without any permanent damage, although full recovery can take many weeks.
Meningitis can be caused by viral, bacterial, or fungal infection or by brain. It results in inflammation of the meninges the membranes covering the brain and spinal cord. Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring. Mar 21, 2019 viral and bacterial infections are the most common causes of meningitis. Viral meningitis is a challenge to the scientific community because of the identification of resource use and associated costs for viral meningitis using database analysis, this study documents various resources consumed as part of routine management of suspected meningitis, culminating with a discharge with a diagnosis of viral meningitis. Viral meningitis itself is not considered to be contagious. It is usually caused by an infection from one of a group of viruses known as enterovirus, such as coxsackievirus and echovirus. Symptoms commonly include headache, fever, sensitivity to light and neck stiffness viruses are the most common cause of aseptic meningitis. Viral meningitis treatment algorithm bmj best practice us. Although viral meningitis is more common than bacterial meningitis, treatment with injectable antibiotics should be started until a bacterial cause can be excluded. Increased intracranial pressure in the setting of enterovirus.
Recovery is usually complete and associated with low mortality rates. Hsv1 typically causes encephalitis rather than meningitis. Viral meningitis can also be a complication of mumps, chickenpox, or other viral diseases. Viral infection is the most common cause of acute aseptic meningitis. There is no specific treatment for viral meningitis and most people recover within a week to ten days. Vsu student health center nursing staff what is meningitis. Viral meningitis usually occurs during the sum mer months and can be. Other causes are rare such as carcinomatous meningitis, intracranial tumors, medications some antibiotics and. Clinical diagnosisthe classical symptoms and signs of acute meningitis may be. Antibiotics are usually discontinued if viral meningitis is diagnosed. Diagnosis and treatment of viral encephalitis postgraduate. Jun 01, 2020 however, an hhv6 pcr test, part of a viral pcr panel, was positive with viral load of 999,999 k copyml, and serum viral load was 283,000 k copyml. However, incidental and nonneurotropic viruses account for the majority of viral meningitis cases. Emergency diagnosis and treatment of adult meningitis the.
Meningitis must be considered in any patient presenting with fever and headache. Meningococcal meningitis is caused by the bacteria neisseria meningitidis, and causes a more severe disease that requires prompt treatment of the patient with antibiotics. It is important to distinguish viral meningitis from bacterial meningitis, which is associated with significant morbidity and mortality and requires urgent treatment. November 2006 viral meningitis is also available in portable document format pdf, 15kb, 2pg. Antimicrobial and support therapy for bacterial meningitis in. Acute encephalitis constitutes a medical emergency. Viral meningitis also called aseptic meningitis is the most common type of infectious meningitis. For most of the cases, there is no specific treatment for viral meningitis.
Survivors of bacterial meningitis may require ongoing treatment or therapy after their recovery. Whitley rj 2004 practice guidelines for the management of. Delays in recognition and treatment of bacterial meningitis can be fatal or result in neurological damage. There is no specific treatment for viral meningitis. Infection of the fluid in the spinal cord and the fluid that surrounds the brain viral or bacterial etiology is important because of the seriousness of the illness and the treatment needed viral meningitis usually clears up in a week or two with no specific treatment common. Viral meningitis is seen most often in children and young adults, but anyone can get viral meningitis.
Contact with an infected person does not increase the risk of developing inflammation. With increased use of conjugate vaccines, the annual incidence of bacterial meningitis in the united states declined from 1. Rare causes of viral meningitis include influenza, parainfluenza, rotavirus, vaccinia, and encephalomyocarditis virus. Communityacquired acute meningitis and encephalitis.
What is the difference between viral and bacterial meningitis. Viral meningitis is an infection of the meninges a thin lining covering the brain and spinal cord by any one of a number of different viruses. It is an uncommon disease but requires urgent treatment with antibiotics to prevent permanent damage or death. A 22yearold woman presented with a 3week history of fever, headache, neck stiffness, rigours and confusion. Difficult and recurrent meningitis journal of neurology. It is rare to find any linked cases that indicate the disease spread through contact between individuals. Aug 27, 2019 treatment is focused on reducing swelling and inflammation around the brain and on maintaining your physical comfort as you recover. Recovery survivors of bacterial meningitis may require ongoing treatment or therapy after their recovery. The 2016 uk meningitis guidelines recommend an lp be performed. Viral meningitis boston health care for the homeless program. Meningitis is an infection of the tissues covering the brain and spinal cord meninges. It is most often spread through respiratory droplets kissing, coughing, sneezing or faecal contamination. Meningitis infection of the coverings of the brain and spinal cord is a serious illness.
Most people who get viral meningitis completely recover on their own within 7 to 10 days and doctors often will recommend bed rest, plenty of fluids and medication to relieve the symptoms of fever and headache. Aseptic meningitis in infants younger than 2 years of age. Table 1 lists the causes of viral meningitis by frequency. Sep 01, 2017 aseptic meningitis is the most common form of meningitis with an annual incidence of 7. In cases of viral meningitis it is not always possible to identify the type of virus responsible for the disease approximately 3040% of patients have no pathogen identified. Diagnosis, initial management, and prevention of meningitis. Viral vs bacterial meningitis fact sheet pdf 80kb view, download and print the viral vs bacterial meningitis fact sheet. Disease fact sheet viral meningitis what is meningitis.
Pharmacologic treatment of meningitis and encephalitis in adult. Acute viral meningitis is most commonly a disease of children and young adults and is the most frequent cns complication of viral infection. Viral meningitis symptoms, diagnosis and treatment bmj. Meningitis due to hsv2 recurs in about 20% of patients. Treatment usually involves measures to relieve symptoms.
Incidence, aetiology, and sequelae of viral meningitis. Meningitis can only be diagnosed by doing specific lab tests on specimens from a person suspected of having meningitis. Treatment for viral meningitis is generally supportive. Meningitis caused by bacteria is the most likely form of the disease to cause serious, longterm complications. In most cases, there is no specific treatment for viral meningitis. Emergency diagnosis and treatment of adult meningitis. She was noted to have a purpuric rash over her hands and feet. Early diagnosis of viral meningitis may allow antibiotics to be stopped and patients to be discharged from the hospital. If nausea is severe, fluid and electrolyte support may be needed. Acute disseminated encephalomyelitis is a noninfective inflammatory encephalitis that may require to be treated with steroids. It is usually less severe than bacterial meningitis. Bacterial meningitis remains one of the most dreaded infections, but rapid diagnosis and early treatment can significantly reduce both the mortality and longterm neurological sequelae. Mostly people completely recover on their own within 7 to 10 days. Viral meningitis nonbacterial meningitis fact sheet.
However disease from certain viruses such as herpesvirus and influenza requires treatment with an antiviral medication. Most cases of aseptic meningitis are viral and require supportive care. Suspected infective meningitis should always be considered as a medical emergency. Viral meningitis is the most common type of meningitis, an inflammation of the tissue.
The most important decision is whether to initiate antimicrobial therapy empirically for bacterial meningitis while waiting for the cause to be identified. Very often, the causative organism is never identified, or obtaining serological proof of a particular viral infection is delayed, though pcr is improving the speed of microbiological diagnosis. Although hiv is a rare cause of viral meningitis, it is important that adults with viral meningitis due to unknown cause undergo an hiv test. Viral meningitis is a common disease caused by a virus that infects the outer covering of the brain and spinal cord. Viral meningitis is the most common form of meningitis and is caused by an infection with one of several types of viruses. Meningitis in children beyond the basics acute disseminated encephalomyelitis adem in children. Viral meningitis british medical bulletin oxford academic. Review diagnosis and treatment of viral encephalitis. Bacterial meningitis can be fatal or cause severe impairment, particularly if the. Whats the difference between bacterial and viral meningitis.
Viral meningitis is usually a benign, selflimited illness. Its typically mild and goes away without treatment. Cerebrospinal fluid proteome maps detect pathogenspecific. Viral meningitis is an infection caused by viruses and bacterial meningitis is an infection caused by bacteria. Clinicians need a low threshold for suspecting meningitis, to undertake appropriate investigations and provide treatment in a timely manner, to minimise the risk of poor outcome in bacterial disease, while limiting unnecessary treatment in viral meningitis. Pdf guidelines for the management of acute meningitis in children.
With a diagnosis of intracranial hypertension secondary to hhv6 meningitis, acetazolamide 500 mg twice daily and ganciclovir 650 mg twice daily were initiated. Meningitis is an infection of the fluid of a persons spinal cord and the fluid that surrounds the brain. Nonpolio enteroviruses account for more than 85% of all cases of viral meningitis. Clinical manifestations, diagnosis, treatment, and prevention of viral meningitis and bacterial meningitis are discussed separately. Viral vs bacterial meningitis middlesexlondon health unit. Viral meningitis, also known as aseptic meningitis, is a type of meningitis due to a viral infection. Most people with viral meningitis recover fully within a week. Pdf bacterial paediatric meningitis laboratory diagnosis.
Most cases of recurrent viral meningitis are caused by hsv2. The most common symptoms are fever, headache, and neck stiffness. Viral meningitis is the most common type of meningitis in adults and older children. Nov 19, 2012 viral meningitis is caused by the nonpolio enterovirus in 85% of cases and is often selflimiting in nature. How to differentiate bacterial from viral meningitis core. All types of meningitis share many symptoms so a clinical. Viral meningitis mimicking benign intracranial hypertension. Meningitis louisiana department of health louisiana. Viral meningitis is a virusborne inflammation of the meninges, which are the. Viral meningitis is usually less severe and resolves without special treatment. In most cases, the presence of focal neurological signs and focal seizures will distinguish encephalitis from encephalopathy.
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