What is Viral Meningitis?

Viral meningitis, or aseptic meningitis, is a viral infection of the meninges, the membranes around the brain, and spinal cord. Viral meningitis is usually less severe than bacterial meningitis, though a doctor should assess all suspected cases of meningitis. There are thought to be around 75,000 cases of viral meningitis in the United States each year, up to 50,000 of which require hospitalization.[1][2]

There are a number of common viruses that can cause viral meningitis. Symptoms include headache, nausea, vomiting, irritability, loss of appetite, and drowsiness.

Viral meningitis is most common in newborns, young children, and people with weakened immune systems. Although most people do not require any specific treatment for viral meningitis, some may need antiviral medications. The prognosis for someone with viral meningitis is generally good.

Viral meningitis vs. bacterial meningitis

Whereas a virus causes viral meningitis, bacterial meningitis is caused by certain bacterial infections and can be far more severe than viral meningitis. Bacterial meningitis includes the potentially lethal meningococcal disease. Because early symptoms of different meningitis can look similar, it is imperative to be assessed by a doctor as soon as possible to identify the cause.[3][4]

Read more about Bacterial Meningitis.»

Symptoms of viral meningitis

Typical symptoms of viral meningitis include:[1][5][6]

  • Fever
  • Headache
  • Photophobia, or sensitivity to bright light
  • Stiff neck
  • Nausea
  • Vomiting
  • Lack of appetite
  • Feeling sleepy or having trouble waking up
  • Lack of energy
  • Lack of coordination
  • Inability to concentrate

Symptoms in newborn babies and young children can include:[1][5][7][8]

  • Fever
  • Vomiting
  • Diarrhea
  • Stiff neck
  • Bulging fontanel, the soft spot on the head
  • Irritability
  • Restlessness
  • Lack of energy
  • Feeling sleepy or having trouble waking up
  • Being unwilling to feed
  • Muscle aches
  • Runny nose
  • Cough
  • Jaundice
  • Slightly red rash
  • Seizures

A person with viral meningitis may also show the virus’s symptoms that make them ill. For example, a person with an enterovirus may also experience:[9][10]

  • Skin rash
  • Runny nose
  • Sneezing
  • Cough
  • Aching muscles
  • Blisters in the mouth and throat

People experiencing possible symptoms associated with viral meningitis should consult a doctor.

Causes of viral meningitis

Viral meningitis is caused by various viruses that sometimes cause inflammation of the meninges, the membranes surrounding the brain and spinal cord.

Good to know: Only a few people who catch the following viruses will develop viral meningitis. People with compromised immune systems, for example, because of chemotherapy, organ transplant, or autoimmune disease, and young children are more at risk of developing viral meningitis.[1]

Non-polio enteroviruses cause 85 percent of cases of viral meningitis. Enteroviruses generally cause mild illnesses, such as the common cold, or produce no symptoms at all. Babies and people with compromised immune systems are likely to develop complications, such as viral meningitis from an enterovirus.[2][9][10]

Herpesviruses, including the herpes simplex virus and varicella-zoster (chickenpox) virus, are the next most common cause of viral meningitis. Herpes simplex virus 2, or HSV-2, is more associated with viral meningitis. Herpes simplex-related cases of viral meningitis may cause Mollaret meningitis and can be very serious for newborn babies.[11][12]

Mumps and measles can cause viral meningitis. Due to a fall in vaccination rates in some areas, viral meningitis caused by mumps and measles is most often seen in young adult populations where immunization rates have fallen.[11][12]

Other viruses that can cause viral meningitis include:[1][11][12][13][14][15]

  • Arboviruses such as West Nile virus and dengue
  • Japanese B encephalitis
  • Tick-borne encephalitis
  • Cytomegalovirus, mainly of risk to people with weakened immune systems
  • HIV, occurring shortly after infection
  • Lymphocytic choriomeningitis, or LCM, which is carried by rodents

Diagnosis of viral meningitis

Diagnosis is based on the symptoms, a physical examination, and testing a cerebrospinal fluid sample, a clear, colorless liquid in the brain and spinal cord.

The cerebrospinal fluid is taken in a lumbar puncture procedure, also known as a spinal tap. To have a lumbar puncture performed, a person sits upright while a healthcare professional cleans their lower back. A needle is then inserted between two vertebrae to remove a small amount of cerebrospinal fluid for testing. A lumbar puncture should take no more than five minutes.[16][17]

The cerebrospinal fluid will be tested to assess whether the meningitis is viral or caused by another organism and identify the responsible virus. These results will inform treatment.[5]

Other samples may be needed to identify which virus is causing meningitis in some cases. These samples can include:[1][6]

  • Blood
  • Throat or nose swab
  • Stool

Treatment of viral meningitis

Most people with viral meningitis will recover without treatment within 7 to 10 days. People with the condition may find over-the-counter medications such as paracetamol helpful to ease symptoms and should drink plenty of fluids.[1]

An essential early step in treating meningitis is identifying whether the condition is viral or bacterial. As bacterial meningitis is typically more severe than the viral variety, intravenous antibiotics will likely be promptly administered if suspected, even if it has not been fully confirmed through testing. Antibiotics are ineffective against viral meningitis.

If the herpes simplex virus causes viral meningitis, it should be treated intravenously with acyclovir’s antiviral drug.[11][18] If a person displays signs of disturbed consciousness or any other neurological problems, acyclovir should be administered early to halt the potential development of encephalitis. People in an unstable condition should be admitted to a critical care unit for airway protection, neurological checks, and to help reduce the possibility of secondary complications. Treatment methods may be altered, depending on gram staining, cultures, and other tests.

Viral meningitis caused by enteroviruses or the herpes simplex virus is capable of causing viral septic shock in newborn babies and infants. For this reason, acyclovir and a broad range of other antiviral therapies should be introduced as soon as the diagnosis is suspected.

Antiretroviral drugs can be used to treat viral meningitis in people with HIV.[6]

Good to know: Viral meningitis is caused by a virus, so antibiotics will not help to combat symptoms. Antibiotics treat illnesses caused by bacteria. However, if a person presents as seriously ill, they will likely be given antibiotics until it is confirmed whether meningitis is bacterial or viral.[6]

Preventing viral meningitis

Protection against some viruses that cause viral meningitis can be obtained through vaccination, such as for mumps, measles, and varicella-zoster.[1]

There are no vaccinations for enteroviruses, but maintaining good hygiene practices, such as handwashing and avoiding close contact with ill people, can restrict their spread.[1]

Using barrier devices, such as condoms, during sexual activity can help restrict the spread of herpes simplex viruses.[2]

Taking precautions to avoid mosquito bites, such as repellent sprays and clothes that cover arms and legs, can prevent the spread of some viruses carried by mosquitoes and which can cause viral meningitis. Some viruses, such as dengue and Japanese encephalitis, are primarily encountered while traveling. However, some mosquito-borne viruses, such as the West Nile virus, are found within the United States.[14][19]

Complications of viral meningitis

In rare cases, viral meningitis can cause more severe conditions. People most at risk include babies less than one-month-old and people with compromised immune systems.

Complications may include persistent headaches and a feeling of general illness (malaise), which may last for up to three weeks. Seizures are also possible and should be treated with intravenous anticonvulsant medications, such as lorazepam, phenytoin, and midazolam. In severe encephalitis, cerebral edema (fluid on the brain) may also occur in some instances. Treatment may involve intracranial pressure control through an infusion of mannitol, intravenous dexamethasone, or intubation.

Viral meningitis caused by the West Nile virus, Japanese B encephalitis, and tick-borne encephalitis can be life-threatening and cause long-term neurological problems.[11]

Mollaret meningitis, also called Recurrent Lymphocytic Meningitis, is a rare form of viral meningitis that repeatedly recurs, separated by weeks or months without symptoms. People with Mollaret meningitis may also experience seizures, double vision, hallucinations, and other neurological problems. It is thought that the herpes simplex virus causes most cases.[17]

Long-term effects of viral meningitis

The majority of people who experience viral meningitis will experience no long-term effects due to the condition. However, there is research to suggest that a small percentage of affected people may develop short-term memory loss and behavioral changes. Children under age may also develop slight neurological problems later in life.[12]

People concerned about the long-term effects of meningitis should talk to their doctor.

Neonatal herpes simplex meningitis

Herpes simplex virus affects around 1,500 to 2,000 newborn babies in the United States each year. If left untreated, the virus can cause viral meningitis. This condition can be life-threatening and can cause lasting brain damage.[18][19]

Viral meningitis FAQs

u003cstrongu003eIs viral meningitis contagious?u003c/strongu003e

Viral meningitis itself is not contagious, meaning it cannot be transmitted from person to person. However, u003cstrongu003esome of the viruses that can cause viral meningitis, notableu003c/strongu003e enteroviruses, are highly contagious, though only a small number of people with these viruses will develop viral meningitis.

u003cstrongu003eWhat is the difference between viral and bacterial meningitis?u003c/strongu003e

Viral meningitis and bacterial meningitis are caused by different organisms. Viruses cause viral meningitis, and bacteria cause bacterial meningitis. Bacterial meningitis can be life-threatening within just a few hours of onset. While viral meningitis is usually far less severe, people in at-risk groups such as babies and immunocompromised people may experience significant complications.u003cbru003eu003ca href=u0022https://adoctor.org/conditions/bacterial-meningitis/u0022u003eRead more about Bacterial Meningitis.»u003c/au003e

u003cstrongu003eIs there a vaccine for viral meningitis?u003c/strongu003e

There is no vaccine available for non-polio enteroviruses, the underlying cause of 85 percent of cases of viral meningitis. There are vaccines for other possible causes, such as u003ca href=u0022https://adoctor.org/conditions/influenza-infection/u0022u003ethe fluu003c/au003e, u003ca href=u0022https://adoctor.org/conditions/measles/u0022u003emeaslesu003c/au003e, and chickenpox. It is advised that people stay up to date on their vaccinations to help prevent viral meningitis.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=5009u0026amp;action=edit#fn1u0022u003e[1]u003c/au003eu003c/supu003e

Other names for viral meningitis

  • Aseptic meningitis
  • Viral meningoencephalitis

  1. Centers for Disease Control and Prevention. “Viral Meningitis.” April 2016. Accessed June 29, 2018.

  2. Medscape. “Viral Meningitis.” July 2018. Accessed June 29, 2018.

  3. Centers for Disease Control and Prevention. “Bacterial Meningitis.” January 2017. Accessed June 29, 2018.

  4. Centers for Disease Control and Prevention. “Meningococcal Disease.” March 2017. Accessed June 29, 2018.

  5. US National Library of Medicine. “Viral meningitis.” January 2008. Accessed June 29, 2018.

  6. MSD Manual: Professional Version. “Viral Meningitis.” November 2017. Accessed June 29, 2018.

  7. UpToDate. “Patient education: Meningitis in children.” October 2017. Accessed June 29, 2018.

  8. Medscape. “Neonatal Meningitis Clinical Presentation.” February 2018. Accessed June 29, 2018.

  9. Centers for Disease Control and Prevention. “Non-Polio Enterovirus.” October 2017. Accessed June 29, 2018.

  10. Medscape. “Enteroviruses.” March 2018. Accessed June 29, 2018.

  11. British Medical Bulletin. “Viral meningitis.” February 2005. Accessed June 29, 2018.

  12. Meningitis Research Foundation. “Viral meningitis.” Accessed June 29, 2018.

  13. Centers for Disease Control and Prevention. “Cytomegalovirus (CMV) and Congenital CMV Infection.” June 2018. Accessed June 29, 2018.

  14. Centers for Disease Control and Prevention. “West Nile virus.” July 2018. Accessed June 29, 2018.

  15. Centers for Disease Control and Prevention. “Lymphocytic Choriomeningitis (LCM).” May 2014. Accessed June 29, 2018.

  16. MedlinePlus. “Cerebrospinal Fluid (CSF) Analysis.” April 2018. Accessed June 29, 2018.

  17. Patient. “Lumbar Puncture.” December 2017. Accessed June 29, 2018.

  18. American Family Physician. “Aseptic Meningitis in the Newborn and Young Infant.” May 1999. Accessed June 29, 2018.

  19. Centers for Disease Control and Prevention. “Arboviral Diseases, Neuroinvasive and Non-neuroinvasive 2015 Case Definition.” Accessed June 29, 2018.

**What is Viral Meningitis? A Comprehensive Guide**

**Q: What⁤ is Viral Meningitis?**

**A:** ‍Viral ‍meningitis is a viral infection‍ of the meninges, the protective membranes that⁤ line the brain and spinal cord. It‌ is most commonly‌ caused by enteroviruses, which‌ are common viruses that can also cause respiratory and gastrointestinal infections.

**Q: What are the Symptoms of Viral Meningitis?**

**A:** Symptoms of viral meningitis typically include:

* Fever

* Headache

* Neck‍ stiffness

* Nausea and vomiting

* Sensitivity to light (photophobia)

* Confusion and disorientation

* Muscle weakness

* Seizures

**Q: How is Viral Meningitis Diagnosed?**

**A:** Viral ​meningitis is diagnosed through a⁣ physical examination, a medical ⁢history, and a laboratory analysis of cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord.

**Q: What is⁢ the⁣ Treatment for Viral Meningitis?**

**A:**⁣ There is ⁤no specific cure for viral meningitis. Treatment focuses on relieving symptoms and preventing complications. It ​may include:

* Bed rest

* Medications ⁣to reduce ⁤fever and pain

* ​Antiviral medications to treat the underlying virus

* ‌Intravenous ‌fluids​ to prevent dehydration

**Q: What are the Complications of‌ Viral Meningitis?**

**A:** In rare cases, ‌viral meningitis can lead to ​complications ⁤such as:

* Encephalitis (inflammation of the brain)

* Stroke

* Hydrocephalus (accumulation ⁣of ⁣fluid‍ in ​the brain)

* Hearing loss

* Psychological problems

**Q: How can I Prevent Viral Meningitis?**

**A:**​ To prevent‌ viral meningitis, you can:

* Wash your hands frequently with soap and water

* Avoid contact with people who are sick

*⁣ Cover your mouth‍ and ⁤nose when you cough or sneeze

* Get vaccinated against​ certain‌ types of enteroviruses

**Q: What is the Prognosis⁤ for‌ Viral Meningitis?**

**A:**⁢ Most people with viral meningitis ⁣recover fully. However,⁣ some people may experience long-term problems ‍such⁣ as hearing loss or⁤ psychological issues.

**Q: When should I‌ seek Medical Attention‌ for Viral Meningitis?**

**A:** If you experience any symptoms of viral meningitis, ⁤it is important to seek⁢ medical attention promptly. Early diagnosis ‌and treatment can help prevent serious complications.

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