Viral meningitis and encephalitis

 

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Aetiologic agents of meningitis

Enterovirus

HSV -2

Poliovirus

 

Aetiological agents of encephalitis

HSV -1

VZV

Mumps

Rubella

Measles

Rabies

Tick borne encephalitis

Japanese encephalitis virus

West Nile virus

St Leouse encephalitis virus

 

Immunocompromised patients

CMV

HHV 6

Adenovirus

JC virus

 

Assessment

Meningitis

Fever, headache, vomiting

Stiff neck, signs of increased intracranial pressure

 Encephalitis

Headache

Seizure

Altered state of consciousness

 

Investigation

Meningitis

CSF- cell count, protein and sugar level

Intracranial pressure

Encephalitis

CT scan/ MRI

 

Diagnostic Tests

Meningitis

CSF- PCR for enterovirus, HSV 2

Throat swab or stool for virus isolation

Encephalitis

CSF- PCR for HSV 1, influenza A, HHV 6, CMV, JC virus

 

 

 

Management

Meningitis- commonly mild and self- limited.

Mainly supportive.

Acyclovir may be used to treat patients with herpes simplex or Varicella Zoster.

Immunocompromised patients with HHV 6 or CMV may be treated with Gancyclovir.

 

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