Aseptic meningitis

Inflammation of the membranes surrounding the brain and spinal cord without a bacterial pathogen.

Meningitis - Lumbar puncture

• Viral meningitis is the most common type of meningitis, an inflammation of the lining of the brain and spinal cord.
• It is often less severe than bacterial meningitis, and most people get better on their own (without treatment).

Causes

Non-polio enteroviruses are the most common cause of viral meningitis in the United States, especially from late spring to fall. Only a small number of people infected with enteroviruses will actually develop meningitis.

Viral causes include:

• Other viruses that can cause meningitis are
• Mumps virus
• Herpesviruses, including Epstein-Barr virus, herpes simplex viruses, and varicella-zoster virus (which causes chickenpox and shingles)
• Measles virus
• Influenza virus
• Arboviruses, such as West Nile virus
• Lymphocytic choriomeningitis virus

There are multiple types of aseptic meningitis which are differentiated based on its cause.

Atypical Bacteria

• Lyme disease
• Syphilis
• Leptospirosis

Meningitis fungus in brain

Fungi

• Cryptococcal infection
• Coccidioidal infection

Drug-induced aseptic meningitis (DIAM)

Autoimmune diseases

• Systemic lupus erythematosus.
• Cancer-caused aseptic meningitis such as neoplastic meningitis
• Neurosarcoidosis

People at Risk

• People of any age can get viral meningitis. However, some people have a higher risk of getting the disease, including:
• Children younger than 5 years old
• People with weakened immune systems caused by diseases, medications (such as chemotherapy), and recent organ or bone marrow transplantations
• Babies younger than 1 month old and people with weakened immune systems are also more likely to have severe illness.

FLAIR MRI of meningitis

Transmission

Close contacts of someone with viral meningitis can become infected with the virus that made that person sick. However, these close contacts are not likely to develop meningitis. Only a small number of people who get infected with the viruses that cause meningitis will actually develop viral meningitis. Viruses that can cause meningitis include:

• Non-polio enteroviruses
• Mumps virus
• Herpesviruses, including Epstein-Barr virus, herpes simplex viruses, and varicella-zoster virus
• Measles virus
• Influenza virus
• Arboviruses, like West Nile virus
• Lymphocytic choriomeningitis virus

Symptoms

Common symptoms in babies:

• Fever
• Irritability
• Poor eating
• Sleepiness or trouble waking up from sleep
• Lethargy (a lack of energy)

Common symptoms in children and adults:

• Fever
• Headache
• Stiff neck
• Photophobia
• Sleepiness or trouble waking up from sleep
• Nausea
• Irritability
• Vomiting
• Loss of appetite
• Lethargy (a lack of energy)

Course

Most people with mild viral meningitis usually get better on their own within 7 to 10 days. Initial symptoms of viral meningitis are similar to those for bacterial meningitis.

Complications

• Rare complications include brain damage, hearing loss, or learning disabilities.
• The pathogens (germs) that cause bacterial meningitis can also be associated with another serious illness, sepsis.
• Sepsis is the body’s extreme response to infection.
• Without timely treatment, sepsis can quickly lead to tissue damage, organ failure, and death.

Diagnosis

Meningitis is diagnosed by ordering specific lab tests on specimens from a person suspected of having meningitis. Samples are collected by:

• Swabbing your nose or throat
• Obtaining a stool sample
• Taking some blood
• Lumbar puncture

Treatment

• In most cases, there is no specific treatment for viral meningitis.
• Most people who get mild viral meningitis usually recover completely in 7 to 10 days without treatment.
• Antiviral medicine may help people with meningitis caused by viruses such as herpesvirus and influenza.
• Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis.
• People who develop severe illness, or are at risk for developing severe illness may need care in a hospital.

Prevention

There are no vaccines to protect against non-polio enteroviruses, which are the most common cause of viral meningitis.

Some preventive measures include:

• Wash your hands often with soap and water for at least 20 seconds, especially after changing diapers or using the toilet
• Avoid close contact, such as touching and shaking hands, with people who are sick
• Clean and disinfect frequently touched surfaces
• Stay home when you are sick and keep sick children out of school
• Vaccines can protect against some diseases, such as measles, mumps, chickenpox, and influenza, which can lead to viral meningitis.
• Make sure you and your child are vaccinated on schedule.
• Avoid bites from mosquitoes and other insects that carry diseases that can infect humans.
• Control mice and rats.

If you have a rodent in or around your home, follow appropriate cleaning and control precautions.

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