What about other causes of meningitis,
We do see that viruses cause meningitis.
This is more common in children.
It's often present during the summer months.
And we think about certain types of
arboviruses, and adenoviruses. And you can
see some of those specific organisms here.
We ask about tick exposure.
We need to think about mosquito bites,
particularly in seasons where this could
occur and could contribute to a viral
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.
Again, we see signs that the virus is all
over the body and causing irritation of other
organisms in selected patients.
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
Signs and symptoms often abate within a week.
And the treatment for a viral process is
typically supportive care.
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
And this is an inflammatory process that
occurs and really causes substantial
neurologic sequelae, and it's important to
remember after mumps infections.
There are certain viruses that we need to
think about, varicella, Epstein Barr, human
herpes virus 6.
Those care is supportive for those,
There's also some non-viral causes of
rickettsia infections, listeria is something
that we've talked about in treatment, and
ehrlichiosis where we see other signatures in
And important, we also see aseptic causes of
a meningitis, non-infectious,
non-bacterial infectious causes that are
coming from some other source.
And we've got to figure out what the source
It could be a medicine and we think about
methotrexate, intravenous immunoglobulin.
Carbamazepine is an antiepileptic that we
can see this with.
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.