Viral Meningitis

This fairly common but rarely severe clinical syndrome arises from certain viruses. It features a sudden onset, subfebrile or febrile temperature, meningeal signs, and an increased cell count in the cerebrospinal fluid, with lymphocytes usually predominating and, less commonly, an elevated protein level while glucose levels remain normal. If meningitis arises from echoviruses or Coxsackie viruses, a vesicular or petechial rash may appear on the soft palate, and less frequently, a rash similar to rubella on the skin. Enterovirus-induced meningitis may also present with respiratory or gastrointestinal symptoms.

Determining the etiology of viral meningitis involves isolating the pathogen in cell culture from nasopharyngeal secretions, stool, blood, or cerebrospinal fluid, or detecting virus nucleic acid using the PCR method. Utilizing all available modern laboratory diagnostic methods, the specific virus causing meningitis can be identified in about 50% of cases. Many different viruses can cause meningitis. Before universal vaccination, more than 25% of viral meningitis cases stemmed from the mumps virus. Currently, enteroviruses cause many cases of viral meningitis. Other causative agents include the tick-borne encephalitis virus, Herpes simplex and Varicella zoster viruses, lymphocytic choriomeningitis virus, and adenoviruses. Different causative agents exhibit different geographic distribution and seasonality, yet they are widespread worldwide.