Aseptic meningitis

Aseptic meningitis is the inflammation of the meninges, a membrane covering the brain and spinal cord, in patients whose cerebral spinal fluid test result is negative with routine bacterial cultures. Aseptic meningitis is caused by viruses, mycobacteria, spirochetes, fungi, medications, and cancer malignancies.^[1] The testing for both meningitis and aseptic meningitis is mostly the same. A cerebrospinal fluid sample is taken by lumbar puncture and is tested for leukocyte levels to determine if there is an infection and goes on to further testing to see what the actual cause is. The symptoms are the same for both meningitis and aseptic meningitis but the severity of the symptoms and the treatment can depend on the certain cause.

Aseptic meningitis

Neurology

The most common cause of aseptic meningitis is by viral infection. Other causes may include side-effects from drugs and connective tissue disorders.

Signs and symptoms[edit]

Aseptic meningitis is a disease that can depend on the patient's age, however, research has shown some distinct symptoms that indicate the possibility of aseptic meningitis. A variety of patients notice a change in body temperatures (higher than normal temperatures 38-40 °C), marked with the possibility of vomiting, headaches, firm neck pain, and even lack of appetite. In younger patients, like babies, a meningeal inflammation can be noticed along with the possibility of hepatic necrosis and myocarditis. In serious cases, a multiple organ failure can also signal aseptic meningitis and oftentimes, in babies, seizures and focal neurological deficits can be early symptoms of aseptic meningitis. In fact, in newborns, the mortality rate is 70%. The next set of age group, like children, have similar but varying symptoms of sore throat, rashes, and diarrhea. In adults, symptoms and the harshness of them tend to be less in duration. Additionally, the probability of developing aseptic meningitis increases when patients have a case of mumps or herpes.^[2]

Symptoms of meningitis caused by an acute viral infection last between one and two weeks. When aseptic meningitis is caused by cytomegalovirus 20 percent of individuals face mortality or morbidity. If left untreated it can affect an individual's hearing and learning abilities.^[3]

An example of a mumps infection.

Lyme disease

Cryptococcal infection

Drug-induced aseptic meningitis

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Systemic lupus erythematosus

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Neurosarcoidosis

The most common cause of aseptic meningitis is a viral infection, specifically by enteroviruses. In fact, 90 percent of all meningitis cases that are viral are caused by enteroviruses.^[2] Other viruses that may cause aseptic meningitis are varicella zoster virus, herpes, and mumps.^[4] Other causes may include mycobacteria, fungi, spirochetes, and complications from HIV. Side effects of certain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics (e.g., trimethoprim-sulfamethoxazole or amoxicillin), and antiepileptic drugs can also cause aseptic meningitis.^[1]

There are multiple types of aseptic meningitis that are differentiated based on their cause.

Treatment[edit]

If CSF levels are irregular among individuals, they will undergo hospitalization where they receive antiviral therapy. If aseptic meningitis was caused by herpes simplex virus (HSV), the individual will receive acyclovir, an antiviral drug.^[3]

History[edit]

Aseptic meningitis was first described by Wallgren in 1925.^[7] Aseptic meningitis cases have varied historically. Aseptic meningitis caused by mumps has declined in the United States due to the increased use of vaccination which prevents mumps cases from occurring.^[2]

Aseptic meningitis