Meningitis is an inflammatory pathology of the meninges surrounding the brain. Mumps was previously a common cause of viral meningitis in the United States but has decreased recently due to the widespread use of measles, mumps, and rubella (MMR) vaccination. It is more common in winter and early spring. LCMV is a rodent-borne virus, usually spread via inhalation of aerosolized urine or droppings, through vertical transmission and transmission via infected corneal, liver, and kidney transplants is also possible. HSV reaches the central nervous system via the cranial nerves. HSV-1 is more commonly associated with sporadic encephalitis, while HSV-2 can cause a benign recurrent viral meningitis meningitis usually occurs in the absence of genital lesions or a history of prior genital herpes infection. Varicella meningitis can occur without cutaneous lesions. VZV can cause viral meningitis, more commonly with reactivation than in primary infection. Human immunodeficiency virus (HIV) meningitis can be present during seroconversion, occurring in 10 to 17% of symptomatic seroconversion illnesses, with a small number progressing to chronic meningitis. Half of the patients with WNV encephalitis have long-term neurological or psychological sequelae. Mortality is higher in patients who are elderly, immunosuppressed, or have diabetes. It is now endemic in North America and carries a 4 to 13% fatality rate. WNV, which is spread by mosquitoes, can cause meningitis and encephalitis. Įnteroviruses rank as the most common cause of viral meningitis in many places in the world, with up to 12 to 19 cases per 100000 population annually in some high-income countries. In temperate climates, viral meningitis is most common in the summer and autumn months, while it is present year-round in tropical and subtropical areas. In the United States, there are up to 75000 cases of enteroviral meningitis annually. The incidence of viral meningitis has been estimated to range from 0.26 to 17 cases per 100000 people. In countries with high rates of immunization coverage, viral meningitis is more common than bacterial meningitis, with an estimated 3 to 18% of childhood meningitis being bacterial in origin. Vaccinations for Haemophilus influenza type B, Streptococcus pneumoniae, and Neisseria meningitidis have significantly decreased cases of bacterial meningitis. Viral meningitis most commonly occurs in young children, with the incidence decreasing with age. Arboviruses that can cause viral meningitis include West Nile virus (WNV), Zika, chikungunya, dengue, LaCross, Saint Louise encephalitis, Powassan, and eastern equine encephalitis virus. Other viral causes include adenovirus, lymphocytic choriomeningitis virus (LCMV), influenza, parainfluenza, and mumps. Herpesviruses that cause meningitis include herpes simplex virus (HSV) 1 and 2, varicella-zoster virus (VZV), cytomegalovirus, Epstein-Barr virus, and human herpesvirus 6. EtiologyĮnteroviruses (Coxsackie or Echovirus groups) are the most common cause of viral meningitis across all age groups parechoviruses are also common in children. Appropriate and timely evaluation is critical as there are no reliable initial clinical indicators to differentiate bacterial and viral etiologies of meningitis. Viral meningitis is usually a self-limiting illness with a good prognosis. Viral meningitis typically presents with the acute onset of fever, headache, photophobia, neck stiffness, and often nausea and vomiting, although younger children may not show signs of meningeal irritation. Viral causes of meningitis have become more common as the prevalence of bacterial meningitis has decreased due to vaccinations, and viral meningitis is the most common form of meningitis in many countries. Aseptic meningitis, defined by the lack of bacterial growth in cultures, is the most common form, with viruses being a frequent cause. Meningitis is the inflammation of the meninges with an associated abnormal cell count in the cerebrospinal fluid (CSF). Describe interprofessional team strategies for improving care coordination and communication to advance the management of viral meningitis and improve outcomes.Outline the treatment and management options available for viral meningitis.Review the typical presentation of patients with viral meningitis.Identify the common etiologies of viral meningitis.This activity reviews the evaluation and management of viral meningitis and explains the role of the interprofessional team in evaluating and treating patients with viral meningitis. It is most common in young children but is seen across all age groups. Viral meningitis is the inflammation of the meninges caused by a virus.
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