meningitis is inflammation of the meninges, membranes of connective tissue that cover the entire central nervous system (brain and spinal cord) below bony structures (skull and spine). Viral meningitis or viral meningitis is caused by viral infections forks the most common type of meningitis above bacterial, fungal, parasitic and non-infectious (drugs, drugs, diseases) meningitis.
Viral meningitis is usually less severe than bacterial meningitis and many cases go away on their own, but if it gets complicated, meningitis can reach a fatal, life-threatening outcome, so it’s very important to see a doctor before the first few. symptoms so you can make a correct diagnosis.
Viral meningitis can be caused by several types of viruses. The most common of these are non-polio enteroviruses, for example echoviruses and coxsackieviruses. These viruses usually live in the digestive tract and follow a fecal-oral transmission, for example through contaminated food. The incidence of this type of meningitis usually has a strong seasonal character, especially in summer.
Other viruses that can cause meningitis are paramyxoviruses (mumps), herpes viruses (herpes simplex, especially herpes simplex type 2 or genital, herpes zoster, Epstein-Barr), morbiliviurs (measles), influenza (influenza), lymphocytic choriomeningitis virus , some arboviruses (transmitted by mosquitoes and other insects, St. Louis encephalitis, California encephalitis virus, West Nile virus), and HIV (AUXILIA).
But most people infected with these viruses will not develop meningitis, only some people, due to their specific conditions, will develop meningitis. For example, children under 5 years of age and immunosuppressed people are considered at risk.
The main transmission routes are:contact between a localized infection and the bloodstream. food contaminated with enteroviruses (eg, not washing hands after defecation). sexual and genital contact (herpesvirus, syphilis and others). mosquito bites and other insects. some viruses are airborne and inhaled, for example through coughing.
You can often see the use of the term aseptic meningitis to refer to viral meningitis, but aseptic meningitis includes all forms of meningitis in which no organisms are found in conventional studies such as Gram stain, including many types of infections, not just viral, including some bacterial infections. Borrelia burgdorferi (Lyme disease) or Treponema pallidum (syphilis), so it’s a term that tends to go out of use.
The initial symptoms of viral meningitis are usually nonspecific symptoms that occur with other viral infections, such as fever, malaise, muscle pain, headache, respiratory symptoms such as coughing, or digestive symptoms such as vomiting and loss of appetite.
As the infection progresses, other symptoms begin to appear that may already suggest the presence of meningitis. include fever, headache, and never stiffness; the combination of these three symptoms is often enough to start meningitis treatment. These symptoms, however, are practically the same as those that appear in bacterial meningitis and it is very difficult to distinguish them without laboratory tests.
Neck stiffness is a very characteristic symptom and is accompanied by pain when trying to lower the head forward, sometimes it becomes an impossible movement to perform. There is also discomfort when doing other neck movements, but not as much as when lowering the head forward.
diagnosis and treatment
The most common viral meningitis are usually self-limiting and benign in prognosis; most cases heal by themselves. Bacterial meningitis tend to present more intense symptoms, faster evolution and worse prognosis.
For this reason, if meningitis is suspected, the differential diagnosis should be made by analyzing the cerebrospinal fluid. The sample is usually extracted by lumbar puncture into the spinal cord and a culture is performed to confirm whether or not it is a bacterial infection. Blood, stool, throat, nose, or rectum samples are also often studied.
Virus cultures are not usually done, it is more common to look for other tests that are easier to perform. For example, enteroviruses and herpesviruses are detected by Polymerase Chain Reaction and others, such as some arboviruses, are detected by the presence of specific antibodies.
Most cases of viral meningitis recover on their own within a week or two. In these cases, treatment may be limited to symptom relief with anti-inflammatory, analgesic and antipyretic.
Only certain types of viruses have antiviral treatment. Herpes simplex and herpes zoster viruses are usually treated with acyclovir and in cases of HIV antiretrovirals are used.
If the patient has severe symptoms suggestive of bacterial meningitis, antibiotics may be started before culture results are available. If bacterial meningitis is negative, antibiotics are stopped. In this way, the progression of a possible bacterial meningitis is avoided, which, if left untreated, can rapidly evolve and cause irreversible damage.