Viral Meningitis

Viral infections of the leptomeninges and subarachnoid space. TOGAVIRIDAE INFECTIONS; FLAVIVIRIDAE INFECTIONS; RUBELLA; BUNYAVIRIDAE INFECTIONS; ORBIVIRUS infections; PICORNAVIRIDAE INFECTIONS; ORTHOMYXOVIRIDAE INFECTIONS; RHABDOVIRIDAE INFECTIONS; ARENAVIRIDAE INFECTIONS; HERPESVIRIDAE INFECTIONS; ADENOVIRIDAE INFECTIONS; JC VIRUS infections; and RETROVIRIDAE INFECTIONS may cause this form of meningitis. Clinical manifestations include fever, headache, neck pain, vomiting, PHOTOPHOBIA, and signs of meningeal irritation. (From Joynt, Clinical Neurology, 1996, Ch26, pp1-3)

Also Known As:

Networked: 372 relevant articles (15 outcomes, 34 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Bacterial Meningitis
2.	Meningeal Tuberculosis (Tuberculous Meningitis)
3.	Aseptic Meningitis
4.	Virus Diseases (Viral Diseases)
5.	Meningism (Meningismus)

Experts

1.	Sadarangani, Manish: 3 articles (01/2019 - 03/2015)
2.	Solomon, Tom: 3 articles (01/2018 - 09/2015)
3.	Tumani, Hayrettin: 3 articles (11/2017 - 04/2010)
4.	Pfister, Hans-Walter: 3 articles (11/2010 - 04/2003)
5.	Hoen, B: 3 articles (07/2009 - 06/2000)
6.	Klawonn, Frank: 2 articles (01/2021 - 01/2020)
7.	Kuhn, Maike: 2 articles (01/2021 - 01/2020)
8.	Müller-Vahl, Kirsten: 2 articles (01/2021 - 01/2020)
9.	Pessler, Frank: 2 articles (01/2021 - 01/2020)
10.	Skripuletz, Thomas: 2 articles (01/2021 - 01/2020)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Viral Meningitis:

1.	Glucose (Dextrose)FDA LinkGeneric 11/12/1977 - "Patients with viral meningitis usually have normal CSF glucose levels, and, during a recent study, false-positive results of 82Br partition tests were not found. " 12/01/1996 - "CSF glucose levels were lower in bacterial than in viral meningitis (p = 0.014) and in neurological controls (p = 0.05). " 03/01/1985 - "Early on, the CSF in patients with viral meningitis frequently contains a predominance of polymorphonuclear leukocytes and may even have a low glucose level. " 05/01/2005 - "Thwaites' diagnostic score was found to be helpful in differential diagnosis of tuberculous meningitis, however, the usefulness of diagnostic scoring should be validated in large series especially in patients with viral meningitis and low CSF glucose levels." 01/01/1992 - "In areas where sophisticated methods of diagnosis may be hard to come by, the simple procedure of simultaneously estimating the blood and cerebrospinal fluid (CSF) glucose levels may be helpful in distinguishing bacterial meningitis from viral meningitis. "
2.	Proteins (Proteins, Gene)FDA Link 01/01/2021 - "Additionally, both acute bacterial and viral meningitis result in marked reduction of brain-enriched proteins. " 11/01/2020 - "Cerebrospinal fluid examination in DIAM reveals an increased CSF white cell count and an increased proportion of neutrophils and protein, compared with viral meningitis. " 01/01/2011 - "Infants with conditions associated with elevated CSF protein concentrations, including traumatic lumbar puncture and bacterial or viral meningitis, were excluded. " 01/01/2007 - "Based on CSF protein and neutrophil ratio which were found as independent variables, the regression model could predict the patients having BM with 95% and viral meningitis with 93.2% accuracy." 03/01/2004 - "The normal brain CT scan was falsely reassuring and the CSF protein was not due to viral meningitis but to haemorrhage into the pituitary tumour. "
3.	Interleukin-6 (Interleukin 6)IBA 12/01/2012 - "The measurement of IL-6 in the CSF and serum in potentially a very useful diagnostic tool for differential diagnosis of bacterial and viral meningitis." 01/01/2018 - "The detection of the expression levels of IL-6 and PCT in patients with viral meningitis is of great significance for the preliminary diagnosis and rehabilitation of viral meningitis." 01/01/2018 - "The levels of inflammatory factors IL-6 and PCT in serum and CSF of patients with viral meningitis are slightly increased. " 01/01/2018 - "PCT and IL-6 were positively correlated with viral meningitis (r=0.8267, 0.9234). " 01/01/2018 - "Compared with those in control group, the white blood cell (WBC) count, and levels of serum IL-6 and PCT in cerebrospinal fluid of patients with viral meningitis were all increased (p<0.01). "
4.	Acyclovir (Aciclovir)FDA LinkGeneric 04/01/2017 - "There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial. " 01/01/2020 - "The patient rapidly improved on acyclovir and was diagnosed with presumed viral meningitis, as viral PCR and fungal culture were pending at time of discharge. " 01/01/2016 - "Viral meningitis was diagnosed and treated with parenteral acyclovir. " 06/01/2020 - "We report a case of crystalluria in a patient treated empirically with intravenous acyclovir for possible viral meningitis. " 10/01/2007 - "He was administered ceftriaxone, vancomycin, and acyclovir for suspected bacterial and/or viral meningitis. "
5.	C-Reactive ProteinIBA 01/01/1993 - "The ability of serum C-reactive protein (S-CRP) to differentiate between acute bacterial and viral meningitis was evaluated in 235 patients, both children and adults. " 12/22/1984 - "C-reactive protein in case of consecutive bacterial and viral meningitis." 07/01/1984 - "Value of C reactive protein measurement in tuberculous, bacterial, and viral meningitis." 12/01/2012 - "Mean HS-CRP in serum in bacterial meningitis was (8.23) and viral meningitis was (6.36). " 01/01/1995 - "[The value of C-reactive protein for the differentiation of bacterial meningitis from viral meningitis]."
6.	Lactic Acid (Lactate)FDA LinkGeneric 01/01/2008 - "The test for lactate concentration in the blood and CSF and their correlation (CSF/blood coefficient) is effective in differential diagnosis between BPM, serous viral meningitis, non-inflammatory lesions of CNS, for assessment of treatment efficacy, prognosis of the disease outcome." 07/01/2023 - "Cerebrospinal Fluid (CSF) lactate concentration is a promising test to distinguish bacterial from viral meningitis. " 11/02/2021 - "Cerebrospinal fluid (CSF) lactate levels can be used to differentiate between bacterial and viral meningitis. " 01/01/2018 - "The authors concluded that CSF lactate has high sensitivity and specificity in differentiating bacterial from viral meningitis. " 01/01/2018 - "When comparing between bacterial and viral meningitis, the area under the curve for CSF lactate was 0.979. "
7.	CytokinesIBA 07/01/2009 - "In contrast to some previous studies, our investigation showed loss of analogy between CSF cytokine profiles of patients with parenchymal neuro-Behçet's disease and viral meningitis. " 01/01/2018 - "In viral meningitis, proinflammatory cytokines were detected at higher levels in the cerebrospinal fluid (CSF) and might play an important role in the inflammatory process. " 09/01/2010 - "Cytokine and adhesion molecule expression evolves between the neutrophilic and lymphocytic phases of viral meningitis." 06/07/2005 - "It is unclear whether or not the CSF cytokine profiles in viral meningitis differ with the kind of causative virus. " 10/01/2003 - "Research has demonstrated that levels of different cytokines are elevated in aseptic and viral meningitis. "
8.	Immunoglobulin G (IgG)IBA 09/01/2003 - "The B cell repertoire of viral meningitis CSF was predominantly polyclonal, whereas B cell clonal expansion was a prominent feature of the IgG repertoire in three of four MS patients. " 01/01/1989 - "None of the CSF of normal controls, bacterial and viral meningitis cases gave positive antimycobacteria IgG by ELISA while 9.5% of the CSF of bacterial and 14.3% of aseptic meningitis cases gave positive results with IF. " 01/01/1995 - "The purpose of this study was to determine the quantity of de novo synthesized IgG during 24 hours in the liquor of patients of different ages suffering from acute viral meningitis and meningoencephalitis and to establish correlations between the dysfunction of blood-brain barrier and de novo IgG synthesis. " 01/01/2016 - "A total of 150 cerebrospinal fluid samples were analysed by an electrochemiluminescence method, selected according to patient diagnosis: (a) bacterial meningitis confirmed by positive culture (n = 26); (b) bacterial meningitis with negative culture or not performed (n = 15); (c) viral meningitis confirmed by polymerase chain reaction or immunoglobulin G determination (n = 23); (d) viral meningitis with polymerase chain reaction negative or not performed (n = 42); and (e) controls (n = 44). " 01/01/1995 - "[Intrathecal synthesis of immunoglobulin G in patients of various ages with acute viral meningitis and meningoencephalitis]."
9.	Immunoglobulins (Immunoglobulin)IBA 05/06/1982 - "[Immunoglobulins in bacterial and viral meningitis. " 11/01/1979 - "[Immunoglobulins in the serum and cerebrospinal fluid of children with bacterial and viral meningitis]." 12/01/1979 - "The mean levels of all CSF immunoglobulins were raised in acute bacterial meningitis and were significantly greater than the levels found in viral meningitis. " 12/01/1979 - "Cerebrospinal fluid (CSF) immunoglobulins were measured in 62 normal children, in 9 children with purulent meningitis, and in 10 children with presumptive viral meningitis. " 12/01/1976 - "This comparative study showed that the increase of CSF immunoglobulin levels was related to important modifications of the permeability of the blood-brain barrier (especially in case of bacterial meningitis) or to a local in situ production (particularly in case of "viral" meningitis). "
10.	Blood Glucose (Blood Sugar)IBA 03/25/2022 - "CSF-CRP, CSF/blood glucose, PCT and Multiplex-PCR may help in diagnosis and differentiation of bacterial and viral meningitis." 04/01/1995 - "A previously reported statistical model based on a combination of four parameters (total polymorphonuclear cell count in cerebrospinal fluid (CSF), CSF/blood glucose ratio, age and month of onset) appeared effective in differentiating acute viral meningitis (AVM) from acute bacterial meningitis (ABM). " 03/25/2022 - "Patients with bacterial meningitis had significantly higher serum CRP, serum PCT and higher CSF-CRP and significantly lower CSF/blood glucose compared to viral meningitis. " 06/01/2000 - "The aim of this study was to validate a diagnosis model that provides pABM, the probability of bacterial versus viral meningitis, based on four parameters collected at the time of first lumbar tap: cerebrospinal fluid protein level, cerebrospinal fluid polymorphonuclear cell count, blood glucose level, and leucocyte count. " 03/01/1985 - "A CSF glucose level lower than 50 per cent of a simultaneously drawn blood glucose determination is not uncommon in patients with viral meningitis due to mumps, LCM, and herpes simplex. "

Therapies and Procedures

1.	Length of Stay 09/24/2015 - "For the whole cohort, altered sensorium, older age and longer hospital stay were associated with poor outcome (death or neurological disability); viral meningitis was associated with good outcome. " 04/01/2022 - "Increasing knowledge and awareness among clinicians on viral meningitis' lab characteristics might have great impact on duration of hospital stay and thus would be reflected on the patient and the healthcare system as well." 10/31/2022 - "The mean length of stay was 20.1 ± 26.9 days, 12.9 ± 13.6 days, 12.1 ± 13.8 days, and 5.1 ± 6.5 days for records with a diagnosis of cytomegalovirus, viral meningitis/encephalitis, herpes simplex infection, and no viral infection, respectively. " 12/01/2021 - "For patients with confirmed viral meningitis, a significant decrease was found between period 1 and period 2, respectively for the rate of hospitalization (73.9% vs 42.0%; p < 0.05), the length of stay (3[2–5] vs 2[1–3] days; p < 0.05), the empirical antiviral (26.1% vs 14.5%) and antibacterial administrations (29.3% vs 14.5%; p < 0.05). " 01/01/2018 - "The median length of hospital stay for patients with viral meningitis was 4 days (IQR 3-7), increasing to 9 days (6-12) in those treated with antivirals. "
2.	Therapeutics 03/01/2019 - "The usual signs and symptoms do not provide optimal sensitivity and specificity for distinguishing possible BM from viral meningitis (VM), which may lead to a delay in the appropriate antimicrobial therapy. " 12/01/2005 - "This pilot study indicates that metabonomic analysis of cerebrospinal fluid is feasible and a potentially more powerful diagnostic tool than conventional rapid laboratory indicators for distinguishing bacterial from viral meningitis and for monitoring therapy. " 01/01/2005 - "There have been fewer developments in therapies for viral meningitis, and there remain no effective therapies for most pathogens, emphasising the importance of prevention and early diagnosis. " 07/01/1977 - "The complex therapy applied in more than half the cases demonstrates the necessity of attentive follow up of these cases of viral meningitis." 10/01/1950 - "There is at present no effective therapeutic agent for the viral meningitides, but the prognosis is favorable in most of these diseases without specific therapy."
3.	Nursing Care 04/05/1974 - "Nursing care study: Monika: a patient with viral meningitis."
4.	Drug Therapy (Chemotherapy) 10/01/2015 - "Given the different approaches of drug therapy in bacterial and viral meningitis, use of molecular methods is necessary in hospitals to rapidly discriminate between them." 01/01/2018 - "Cryptococcal meningoencephalitis is responsible for upwards of 15% of HIV-related deaths worldwide and is currently the most common cause of non-viral meningitis in the US, affecting both previously healthy and people with immune suppression caused by cancer chemotherapy, transplantation, and biologic therapies. "
5.	Airway Management 06/01/2021 - "Patients should be treated empirically for bacterial, fungal, and viral meningitis, specifically with amphotericin B and flucytosine for presumed CM. Additionally, appropriate resuscitation and supportive care, including advanced airway management, management of increased intracranial pressure (ICP), antipyretics, intravenous fluids, and isolation, should be initiated. "