Viral meningitis
Viral meningitis is an infection of the protective layers surrounding the brain and spinal cord, known as the meninges. It is primarily caused by various viruses, including enteroviruses, herpesviruses, and mumps, among others. Symptoms commonly include high fever, headaches, stiff neck, nausea, and sensitivity to light, with more severe indicators in newborns such as irritability and feeding difficulties. Viral meningitis is generally considered less serious than bacterial meningitis, though the risk factors for developing this condition include weakened immune systems, crowded living conditions, and seasonal variations, particularly in summer and early fall.
Diagnosis typically involves a thorough medical history and physical examination, along with imaging tests like MRI or CT scans, and potentially a lumbar puncture to test cerebrospinal fluid. Treatment focuses on supportive care, including rest and hydration, with nonsteroidal anti-inflammatory drugs provided for relief. Preventative measures emphasize good hygiene practices, vaccinations for preventable viruses, and strategies to minimize mosquito exposure. Overall, while viral meningitis can be concerning, many cases resolve with appropriate care and management.
Viral meningitis
- ANATOMY OR SYSTEM AFFECTED: Brain, central nervous system, spinal cord, tissue
Definition
The brain and spinal cord are encased by layers of tissue called the meninges. Certain viruses can cause an infection in these layers. This infection is called viral meningitis. Some types of viral meningitis can be less serious than bacterial meningitis.
Causes
Several viruses can cause viral meningitis, including enteroviruses, herpesviruses, mumps, varicella virus (chickenpox), measles, rubella viruses, and West Nile virus. Most of these viruses can also cause encephalitis, an inflammation of the brain tissue. It is a much more serious condition.
Viruses that cause meningitis can be spread in numerous ways. Enteroviruses are spread through direct contact with respiratory secretions of an infected person and through feces. Other viruses (mumps, herpes, chickenpox) are spread through close personal contact or the air. Some viruses (such as West Nile) that cause encephalitis are spread by insects.
Risk Factors
Risk factors for viral meningitis include conditions that weaken the immune system, such as human immunodeficiency virus (HIV) infection (which itself can lead to meningitis and encephalitis); immunosuppressive treatments; crowded, unsanitary conditions; and the months of summer and early fall. Age, recent travel, and having close contact with a person with viral meningitis are additional risk factors.
Symptoms
Classic symptoms of viral meningitis include high fever, headache, stiff, sore neck, nausea, vomiting, sensitivity to bright lights, and sleepiness. In newborns and infants, symptoms include inactivity, high fever (especially unexplained high fever), irritability, vomiting, feeding poorly or refusing to eat, tautness or bulging of soft spots between skull bones, and difficulty awakening.
Screening and Diagnosis
A doctor will ask about symptoms and medical history and will perform a physical exam. The doctor will focus on the nervous system. To help rule out other causes of the inflammation, such as a tumor, the doctor may order a magnetic resonance imaging (MRI) scan (a scan that uses radio waves and a powerful magnet to produce detailed computer images) or a computed tomography (CT) scan (a detailed X-ray picture that identifies abnormalities of fine tissue structure).
To rule out bacterial meningitis, the doctor may order a lumbar puncture (spinal tap), which removes fluid from the lower spinal column to be tested for bacteria (bacterial cultures), or the doctor may order other cultures, such as blood, urine, mucus, and pus from skin infections.
Treatment and Therapy
Treatment includes supportive care, such as rest and fluids, nonsteroidal anti-inflammatory drugs (NSAIDs), and aspirin. Aspirin, however, is not recommended for children with a current or recent viral infection. Antibiotics may be given for two to three days while waiting for bacterial cultures to be reported as negative. If encephalitis is present, the doctor may prescribe intravenous (IV) antiviral drugs, such as acyclovir, and other medications.
Prevention and Outcomes
To help prevent infection, one should wash their hands often if in close contact with an infected person, after changing the diaper of an infected infant, or if working in a childcare setting. One should regularly wash objects and surfaces touched by children using a diluted bleach solution. Persons who have not had measles, mumps, rubella, or chickenpox should consider being vaccinated.
Some forms of viral meningitis are spread by mosquito bites. One should follow public health recommendations for reducing mosquitoes near one’s home and should take steps to avoid being bitten by mosquitoes.
If thinking about pregnancy, one should ensure protection (such as a chickenpox vaccine) from common diseases. Also, one should avoid all contact with rodents during pregnancy because lymphocytic choriomeningitis virus can be acquired from pet hamsters, mice, or other rodents. Pregnant women who have a pet rodent should consider finding another home for the rodent for the duration of the pregnancy.
Bibliography
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