Patients with varicella zoster meningitis may present with herpes zoster ( Shingles) in conjunction with classic meningeal signs. Interestingly, research has shown that HSV-2 meningitis most often occurs in people with no history of genital herpes, and that a severe frontal headache is among the most common presenting symptoms. Mumps meningitis can present similarly to isolated mumps, with possible parotid and testicular swelling. Lymphocytic choriomeningitis virus (LCMV) can be differentiated from the common presenting meningeal symptoms by the appearance of a prodromal influenza-like sickness about 10 days before other symptoms begin. With coxsackie and echo virus' specifically, a maculopapular rash may be present, or even the typical vesicles seen with Herpangina. Enteroviral meningitis (the most common cause) typically presents with the classic headache, photophobia, fever, nausea, vomiting, and nuchal rigidity. Symptoms can vary depending on the virus responsible for infection. The first fever arrives with the onset of general constitutional symptoms, and the second accompanying the onset of the neurological symptoms. A biphasic fever is more often seen in children compared to adults. The pediatric population may show some additional signs and symptoms that include jaundice and bulging fontanelles. In severe cases, people may experience concomitant encephalitis ( meningoencephalitis), which is suggested by symptoms such as altered mental status, seizures or focal neurologic deficits. Infection in the neonatal period may be the result of infection during pregnancy. īabies with viral meningitis may only appear irritable, sleepy or have trouble eating. Photophobia is due to meningeal irritation. Widened pulse pressure (systolic - diastolic blood pressure), bradycardia, and irregular respiration would be alarming for Cushing's reflex, a sign of acutely elevated intracranial pressure. Increased cranial pressure from viral meningitis stimulates the area postrema, which causes nausea and vomiting. Nausea, vomiting and photophobia (light sensitivity) also commonly occur, as do general signs of a viral infection, such as muscle aches and malaise. In contrast to bacterial meningitis, symptoms associated with viral meningitis are often less severe and do not progress as quickly. The various layers of meninges act form a separation between the brain and the skull. Neck stiffness is the result of inflamed meninges stretching due to flexion of the spine. Cytokines and increased intracranial pressure stimulate nociceptors in the brain that lead to headaches. Fever is the result of cytokines released that affect the thermoregulatory (temperature control) neurons of the hypothalamus. Viral meningitis characteristically presents with fever, headache and neck stiffness. While the disease can occur in both children and adults, it is more common in children. For enteroviral meningitis, the most common cause of viral meningitis, there are up to 75,000 cases annually in the United States alone. The estimated incidence has a considerable range, from 0.26 to 17 cases per 100,000 people. With the prevalence of bacterial meningitis in decline, the viral disease is garnering more and more attention. In the United States, viral meningitis is the cause of more than half of all cases of meningitis. A few viral causes, such as HSV, have specific treatments. In most cases, there is no specific treatment, with efforts generally aimed at relieving symptoms (headache, fever or nausea). Therefore, lumbar puncture with CSF analysis is often needed to identify the disease. Viral meningitis has no evidence of bacteria present in cerebral spinal fluid (CSF). Based on clinical symptoms, viral meningitis cannot be reliably differentiated from bacterial meningitis, although viral meningitis typically follows a more benign clinical course. However, other viruses can also cause viral meningitis, such as West Nile virus, mumps, measles, herpes simplex types I and II, varicella and lymphocytic choriomeningitis (LCM) virus. Most cases of viral meningitis are caused by enteroviruses (common stomach viruses). Viruses are the most common cause of aseptic meningitis. Symptoms commonly include headache, fever, sensitivity to light and neck stiffness. It results in inflammation of the meninges (the membranes covering the brain and spinal cord). Viral meningitis, also known as aseptic meningitis, is a type of meningitis due to a viral infection. Viral meningitis causes inflammation of the meninges.
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