Acute Viral Meningitis

by Carlo Raj, MD

Questions about the lecture
My Notes
  • Required.
Save Cancel
    Learning Material 2
    • PDF
      Slides 10 CNSInfections Neuropathology I.pdf
    • PDF
      Download Lecture Overview
    Report mistake

    00:01 At this point, we’re going to transition into acute viral meningitis, please.

    00:06 Viral meningitis, officially.

    00:09 Characterized by headache, mild meningismus, fever, altered mental status.

    00:14 Now, with viral, what does that mean to you? Once, again, in your CSF, what kind of findings would you expect? Number one, what about WBC? Elevated.

    00:26 What kind do you think? Less neutrophil, maybe lymphocytes.

    00:31 These are viruses, little bitty structures, they’re skinny.

    00:34 And so therefore, maybe, your protein is elevated, but definitely, not as dramatic as what you’d find with bacterial.

    00:41 And about what glucose? Do viruses truly require glucose for proper metabolism? No.

    00:47 So your glucose levels will be normal.

    00:48 Is that clear? Keep it simple, understand your organisms and take time doing that.

    00:55 So that you’re able to quickly walk through what you can expect to see.

    00:58 Self-limited, supportive care only.

    01:00 These are viruses, right? So we’re going to stay away from antibiotics, won’t we? Topic: Acute viral meningitis.

    01:08 First, we’ll take a look at non-polio enteroviruses 85% of your viral meningitidis or meningitides would be non-polio enterovirus.

    01:17 Echovirus.

    01:18 Coxsackievirus.

    01:20 85%.

    01:21 So if I were you, I’d make sure that I know these viruses.

    01:25 Coxsackie, you’ve seen all over the place, haven’t you? You’ve seen coxsackievirus.

    01:30 Well, we’ve talked about this earlier with viral myocarditis.

    01:34 Coxsackievirus, all over the place.

    01:38 Measly 5%, arboviruses.

    01:42 Now, that 5% though, you need to make sure you know about these organisms including Eastern equine encephalitis, western equine, Saint Louis.

    01:52 And you have 4% of the time perhaps, your herpes virus in here.

    01:55 Specifically, we’ll spend time with HSV-2.

    01:59 Look at what we have here.

    02:02 Isn’t it always nice to take a look at this table? It’s like comfort food, isn’t it? It should be.

    02:07 By the time you're done with this particular section and all these sections, these tables should be like comfort food because it gives you a brief summary of all the things that are occurring.

    02:19 I just walked you through in great detail, this entire table of cerebrospinal fluid findings.

    02:27 We looked at no infection.

    02:28 I walked you through acute bacterial meningitis.

    02:30 And our topic here, was what? Viral meningitis and also HSV.

    02:35 You’ll be focusing upon these two columns, once again.

    02:39 You can expect your WBC count to be elevated.

    02:41 When you’re dealing with HSV specifically, keep in mind that not only could the meninges be affected as could be or as could the parenchyma.

    02:50 And so therefore, we have a combination of the two.

    02:54 We have WBC being elevated.

    02:56 Neutrophils will be on the lower side because these are viruses.

    02:59 Fungal, I’ll come to soon enough.

    03:03 RBCs, especially when dealing with HSV, you’ll notice that this will be elevated due to the fact why? Good.

    03:10 Remember, I told you that if the brain is involved, the parenchyma, then you could expect there to be RBCs to be found in your lumbar puncture or cerebrospinal fluid.

    03:20 The glucose levels here would be, well, not so decreased as what you’d expect with bacterial, right? And finally the protein here, it would be elevated, but definitely not as dramatic as what you’d find with bacterial.

    03:33 At this point, ladies and gentlemen, we have now completed our discussion of briefly viral meningitis.

    About the Lecture

    The lecture Acute Viral Meningitis by Carlo Raj, MD is from the course CNS Infection—Clinical Neurology.

    Included Quiz Questions

    1. Rabies virus
    2. ECHO virus
    3. Coxsackievirus
    4. Herpes simplex virus
    5. St. Louis virus
    1. HSV encephalitis
    2. Acute bacterial meningitis
    3. Fungal meningitis
    4. Rickettsial
    5. No infection

    Author of lecture Acute Viral Meningitis

     Carlo Raj, MD

    Carlo Raj, MD

    Customer reviews

    5,0 of 5 stars
    5 Stars
    4 Stars
    3 Stars
    2 Stars
    1  Star