Viral Meningitis

Symptoms

• younger

• summer

• 2 days malaise

• 24 hours

  • headache

  • stiff neck

  • photophobia

  • vomited

Examination

• temp 39º

• no abnormal neurology

Investigations

• lumbar puncture

  • 340 white cell / mm³ (90% lymphocytes)

  • mild hypoglycoarrachia (low glucose in the CSF)

  • mildly raised proteins

Diagnosis

• viral meningitis

  • but until pathogen identified treat as bacterial and give antibiotics

Potential organisms

• enteroviruses - rarely found

• herpes simplex

• varicella zoster

• if immunocompromised

  • cytomegalovirus (CMV)

  • human herpesvirus 6 (HHV-6)

  • adenoviruses

Laboratory confirmation

• CSF

  • RT-PCR

    • enteroviruses

    • HSV-1 / HSV-2

    • VZV

    • CMV

  • viral culture

    • may take 21 days

• Throat swab

• Stool sample

Prognosis

• good - unlikely to be complications or sequelae even without treatment

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