Diagnostic Advances in Acute Viral Meningitis: Any Novelty for the Physician?

Abstract

Acute viral meningitis (AVM) constitute an important cause of mortality and neurological morbidity within the last decades, in spite of all diagnostic and therapeutic advances in medical technology. Diagnostic procedures consist of lumbar puncture, hemoculture, complete blood cell count (including, leukocytes), procalcitonin, lactate and glucose to give an overall insight for disease; while polymerase chain reaction (PCR) and cerebrospinal fluid (CSF) analyses (urine reagent strips, glucose, protein, and microscopic examination) are used to diagnose herpetic meningeal involvement and most other viral infections affecting central nervous system (CNS). Findings in blood and CSF work-up after a clinical index of suspicion result in a high yield of diagnosis. Technological advances should be coupled with clinical findings to produce an accurate clinical management in the target population. This review is intended to analyze the epidemiology, clinical manifestation, findings on examination, and diagnostic tools to be utilized in patients suspected to have AVM in light of recent advances and research data, and to culminate up-to-date concept of AVM for primary care and emergency physicians.