00:01
What about other causes of meningitis,
non-bacterial causes?
We do see that viruses cause meningitis.
00:07
This is more common in children.
00:08
It's often present during the summer months.
00:11
And we think about certain types of
viruses; enteroviruses,
arboviruses, and adenoviruses. And you can
see some of those specific organisms here.
00:19
We ask about tick exposure.
00:21
We need to think about mosquito bites,
particularly in seasons where this could
occur and could contribute to a viral
transmission.
00:29
The clinical manifestations may vary just
slightly from bacterial meningitis, we can
see an exanthem, a rash, a viral exanthem,
which we see in viral processes more than
bacterial, conjunctival hemorrhage
pleurodynia, pericardial rub.
00:43
Again, we see signs that the virus is all
over the body and causing irritation of other
organisms in selected patients.
00:50
We can see increase in LFTs from a mild
hepatitis from a viral infection, and often
these occur in the viral prodrome prior to
presentation with the acute or subacute
viral meningitis.
01:02
Signs and symptoms often abate within a week.
01:03
And the treatment for a viral process is
typically supportive care.
01:09
There are rare types of viral meningitis
that we may need to consider and can show up
on test questions or certain clinical
vignettes, a rare late complication after a
meningitis that's called subacute
sclerosing panencephalitis.
01:23
And this is an inflammatory process that
occurs and really causes substantial
neurologic sequelae, and it's important to
remember after mumps infections.
01:32
There are certain viruses that we need to
think about, varicella, Epstein Barr, human
herpes virus 6.
01:38
Those care is supportive for those,
lymphocytic choriomeningitis.
01:43
There's also some non-viral causes of
meningitis,
rickettsia infections, listeria is something
that we've talked about in treatment, and
ehrlichiosis where we see other signatures in
those patients.
01:55
And important, we also see aseptic causes of
a meningitis, non-infectious,
non-bacterial infectious causes that are
coming from some other source.
02:03
And we've got to figure out what the source
is.
02:06
It could be a medicine and we think about
methotrexate, intravenous immunoglobulin.
02:10
Carbamazepine is an antiepileptic that we
can see this with.
02:14
Nonsteroidal anti-inflammatories, and there
is a list of other medicines that are
important to research when you're evaluating these
patients or and considering a clinical vignette.