Acute Viral Meningitis

00:01 At this point we're gonna transition into acute viral meningitis, please – viral meningitis, officially.

00:08 The most common symptoms of viral meningitis according to the most recent study published in 2017, are headache, followed by neck rigidity, and nausea/vomiting.

00:22 Self-limited, supportive care only, these are viruses, right? So, we're gonna stay away from antibiotics, won't we? Topic, acute viral meningitis.

00:31 First, we'll take a look at non-polio enteroviruses.

00:35 85% of viral meningitidis or meningitidis, would be non-polio enterovirus.

00:42 Echovirus, coxsackievuris, 85%, so if I were you, I'd make sure that I know these viruses.

00:49 Coxsack, you've seen all over the place, haven't you? You've seen coxsackievirus. Well, we talked about this earlier with viral myocarditis.

00:58 Coxsakievirus all over the place. Immensely, 5%, arboviruses.

01:06 Now, that 5% though, you need to make sure you know about these organisms including Eastern Equine Encephalitis, Western Equine, St. Louis.

01:16 And you have 4% at the time perhaps your herpes virus and here's specifically we'll spend time with, HSV-2.

01:23 Look at what we have here. Isn't it always nice to take a look at this table? It's like comfort food, isn't it? It should be.

01:32 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.

01:43 I just walked you through in great detail this entire table of cerebrospinal fluid findings.

01:50 We looked at no infection, I walked you through acute bacterial meningitis, and our topic here is what? Viral meningitis and also HSV.

01:59 You'll be focusing upon these two columns.

02:02 Once again, you can expect your WBC count to be elevated.

02:06 When you're dealing with HSV specifically, keep in mind that not only it could the meninges be affected as could be or as could, the parenchyma, also therefore we have a combination of the two.

02:17 We have WBC being elevated, neutrophils will be on the lower side because these are viruses, fungal come too soon enough, RBCs, especially when dealing with HSV, you'll notice that this will be elevated due to the fact, why? Good, remember what I told you that if the brain is involved, the parenchyma, then you can expect there to be RBCs to be found in your lumbar puncture or cerebrospinal fluid.

02:44 The glucose levels here would be – well, not so decreased as what you expect with bacterial, right? And finally the protein here would be elevated but definitely not as dramatic as what you find with bacteria.

02:57 At this point, ladies and gentlemen, we have now completed our discussion of – briefly, viral meningitis.