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Viral Meningitis

Viral infection is the commonest cause of meningitis.

Cause:

1. Enterovirus (Echovirus,Coxsackei,Poliovirus).
2. Arbovirus (e.g.yellow fever,sand fly fever).
3. Herpes simplex virus.
4. Mumps virus,Influenza virus.

Clinical features of Viral meningitis:

A) Acute onset of headache.
B) Irritability and rapid development of meningeal irritation with-highpyrexia (revert to normal in 5-7 days)
C) But focal neurological signs are uncommon.

Investigations:

1. CSF examination (See table)

Treatment/Management:

Treatment must be started without waiting for confirmation(culture report).
1. There is no specific treatment,usually benign & self-limiting.
2. Symptomatic treatment in a quiet environment.
3. Recovery usually occurs within days.

Table:CSF findings in different meningitis.

Colour Clear
Pressure Normal
Cell count/cmm Lymphocytes 10-2000
Glucose Normal
Protein Normal/increase
Chloride Normal

Complications of meningitis:

* Abscess-Epidural,Subdural,Brain.
* Causing obstructive hydrocephalus.
* Development of cranial nerve palsy.
* Epilepsy,Mental deficit.
Acute renal failure.
* Development of water-house.
* Friedrickson's syndrome in meningitis.
Reference:Davidson's Principles and Practice of medicine,21st edition,page:1209-1210.

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