Clinical Features of Viral Meningitis in Adults: Significant Differences in Cerebrospinal Fluid Findings among Herpes Simplex Virus, Varicella Zoster Virus, and Enterovirus Infections

Ihekwaba, Ugo K.; Kudesia, Goura; McKendrick, Michael W.

doi:10.1086/591129

Cited by 112 publications

(97 citation statements)

References 15 publications

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“…However, there were other symptoms in these patients (summarized in Table 3). Most previous reports show similar results: headache and fever in all patients, vomiting in 60 to 90%, diarrhea in 11%, and rash in 3 to 9% (Bernit et al, 2004;Gosbell et al, 2000;Ihekwaba et al, 2008;Kao et al, 2003). Why a rash was not observed in our case series remains uncertain.…”

Section: Clinical Featuressupporting

confidence: 60%

Aseptic Meningitis Caused by Enteroviruses

Hayashi¹,

Shirayoshi²,

Ebitani³

2012

Meningitis

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Section: Clinical Featuressupporting

confidence: 60%

Aseptic Meningitis Caused by Enteroviruses

Hayashi¹,

Shirayoshi²,

Ebitani³

2012

Meningitis

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“…Enterovirus infection is the most common cause of viral meningitis in immunocompetent adult [3]. There are no published data revealing that acyclovir will modify the course of VZV meningitis, but it is important to recognize the potential clinical benefit with the early initiation of antiviral therapy, especially if a zoster rash is discovered on examination [4]. The reactivation zoster rash of VZV is seldom associated with aseptic meningitis.…”

Section: Discussionmentioning

confidence: 99%

An Immunocompetent Patient With a Vesicular Rash and Neurological Symptomatology

Cooper

2013

J Med Cases

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Viral infection is the most common cause of aseptic meningitis with the most frequent virus associated with aseptic meningitis being enteroviruses (coxsackievirus and echovirus). In viral meningitis, cerebrospinal fluid (CSF) shows a mild pleocytosis with a lymphocytic predominance, elevated protein, and normal glucose level. Nucleic acid amplification methods have greatly improved the detection of viral pathogens. In our case, a 47-year-old Caucasian female patient presented with a persistent throbbing headache for six days, localized at the frontal area, associated with photophobia, and exacerbated by bright lights and loud noises. Physical examination revealed nuchal rigidity and a vesicular rash at the right T4-T6 dermatome region. CSF findings were consistent with aseptic meningitis and polymerase chain reaction (PCR) was positive for VZV. Clinical improvement in meningeal signs and symptoms occurred after the initiation of acyclovir to complete a total 10-day course. There are no published data revealing that acyclovir will modify the course of VZV meningitis, but it is important to recognize the potential clinical benefit with the early initiation of antiviral therapy, especially if a zoster rash is discovered on examination. However, this is rarely the case because the majority of VZV meningitis will not present with a rash. Even though the reactivation of VZV is not usually associated with clinical meningitis, it is important to consider VZV in the differential diagnosis of a patient presenting without a rash with CNS disease. PCR has been proven to be a useful and quick diagnostic tool in the early diagnosis of VZV-associated neurological disease.

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“…The most common clinical challenge for physicians is whether a meningitis case has a viral or bacterial etiology, as this will influence the therapeutic attitude [3]. The most common viral meningitis are those involving enteroviruses [1].…”

Section: Introductionmentioning

confidence: 99%

Enterovirus Meningitis in Children from Constanta

Bolojan¹,

Cambrea

2017

ARS Medica Tomitana

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Introduction: Many different viruses can cause meningitis. Most children are exposed to some of them during their life without developing meningitis. Of all the viruses, enteroviruses are the most frequent involved in etiology of meningitis. Material and Method: The evaluated group consisted of 73 patients, boys and girls aged 1 to 12 years, hospitalized at Constanta Clinical Infectious Diseases Hospital during the period May 2016 - October 2017. Results: Over the studied period, 243 patients were admitted with suspicion of meningitis, but just 73 of them were confirmed (30.04%). The average age of children with Viral Meningitis was 5 years and 8 months old, with a gender distribution that revealed a 2:1 balance in boy’s favor. The most affected age groups were 1-3 years and 4-6 years with 27 cases each. Fever, headaches and vomiting were the most common symptoms, occurring in majority of the patienst (53/73). Cerebrospinal fluid was clear in 58 cases, meanwhile in 15 cases the fluid was opalescent. Polymerase chain reaction on cerebrospinal fluid revealed Enterovirus in 27 out of the 73 cases. Conclusions: Viral meningitis with enteroviruses should be considered in any paediatric patients admitted with fever, headaches and vomiting, boys and girls, due to the potential outbreaks that can appear during the summer or autumn.

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Clinical Features of Viral Meningitis in Adults: Significant Differences in Cerebrospinal Fluid Findings among Herpes Simplex Virus, Varicella Zoster Virus, and Enterovirus Infections

Cited by 112 publications

References 15 publications

Aseptic Meningitis Caused by Enteroviruses

Aseptic Meningitis Caused by Enteroviruses

An Immunocompetent Patient With a Vesicular Rash and Neurological Symptomatology

Enterovirus Meningitis in Children from Constanta

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