Viral meningitis: current issues in diagnosis and treatment
- PMID: 28118219
- DOI: 10.1097/QCO.0000000000000355
Viral meningitis: current issues in diagnosis and treatment
Abstract
Purpose of review: The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome.
Recent findings: Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions. Despite improvements in diagnostics many laboratories do not use molecular methods and even when they are used many cases still remain without a proven viral aetiology identified. There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial.
Summary: Viruses are in increasingly important cause of meningitis in the era of declining bacterial disease. The exact viral aetiology varies according to age and country. Molecular diagnostics can not only improve the rate of pathogen detection but also reduce unnecessary antibiotics use and length of hospitalization. Further research is required into treatments for viral meningitis and the impact in terms of longer term sequelae.
Similar articles
-
Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's.Herpes. 2004 Jun;11 Suppl 2:57A-64A. Herpes. 2004. PMID: 15319091 Review.
-
Incidence, aetiology, and sequelae of viral meningitis in UK adults: a multicentre prospective observational cohort study.Lancet Infect Dis. 2018 Sep;18(9):992-1003. doi: 10.1016/S1473-3099(18)30245-7. Epub 2018 Jun 29. Lancet Infect Dis. 2018. PMID: 30153934 Free PMC article.
-
Herpes simplex virus 2 meningitis: a retrospective cohort study.J Neurovirol. 2013 Apr;19(2):166-71. doi: 10.1007/s13365-013-0158-x. Epub 2013 Mar 15. J Neurovirol. 2013. PMID: 23494382
-
Diagnostic accuracy of two multiplex real-time polymerase chain reaction assays for the diagnosis of meningitis in children in a resource-limited setting.PLoS One. 2017 Mar 27;12(3):e0173948. doi: 10.1371/journal.pone.0173948. eCollection 2017. PLoS One. 2017. PMID: 28346504 Free PMC article.
-
Herpes simplex virus, meningitis and encephalitis in neonates.Herpes. 2004 Jun;11 Suppl 2:65A-76A. Herpes. 2004. PMID: 15319092 Review.
Cited by 14 articles
-
Viruses Causing Aseptic Meningitis: A Tertiary Medical Center Experience With a Multiplex PCR Assay.Front Neurol. 2020 Dec 7;11:602267. doi: 10.3389/fneur.2020.602267. eCollection 2020. Front Neurol. 2020. PMID: 33424752 Free PMC article.
-
Diagnostic accuracy of cerebrospinal fluid lactate in confirmed cases of acute bacterial meningitis in children.Pak J Med Sci. 2020 Nov-Dec;36(7):1558-1561. doi: 10.12669/pjms.36.7.1682. Pak J Med Sci. 2020. PMID: 33235574 Free PMC article.
-
Differential Diagnosis and Hospital Emergency Management for Fastlane Treatment of Central Nervous System Infection Under the COVID-19 Epidemic in Changsha, China.Front Neurol. 2020 Oct 20;11:555202. doi: 10.3389/fneur.2020.555202. eCollection 2020. Front Neurol. 2020. PMID: 33192989 Free PMC article. Review.
-
Positive Impact of Routine Testing for Enterovirus and Parechovirus on Length of Hospitalization and Antimicrobial Use among Inpatients ≤6 Months of Age.J Clin Microbiol. 2020 Dec 17;59(1):e02106-20. doi: 10.1128/JCM.02106-20. Print 2020 Dec 17. J Clin Microbiol. 2020. PMID: 33055181
-
Investigating the etiologic agents of aseptic meningitis outbreak in Iranian children.J Family Med Prim Care. 2020 Mar 26;9(3):1573-1577. doi: 10.4103/jfmpc.jfmpc_1003_19. eCollection 2020 Mar. J Family Med Prim Care. 2020. PMID: 32509652 Free PMC article.
Publication types
MeSH terms
Substances
Grant support
LinkOut - more resources
Full Text Sources
Other Literature Sources