Viral meningitis

doi:10.1136/bmj.39409.673657.AE

BMJ 2008;336:36-40 (5 January), doi:10.1136/bmj.39409.673657.AE

Clinical review

Viral meningitis

Sarah A E Logan, specialist registrar, Eithne MacMahon, consultant

¹ Infection and Immunology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH

Correspondence to: E MacMahon eithne.macmahon@gstt.nhs.uk

The first 150 words of the full text of this article appear below.

Viral meningitis is common and often goes unreported. In theabsence of a lumbar puncture, viral and bacterial meningitiscannot be differentiated with certainty, and all suspected casesshould therefore be referred. Lumbar puncture and analysis ofcerebrospinal fluid may be done primarily to exclude bacterialmeningitis, but identification of the specific viral cause isitself beneficial. Viral diagnosis informs prognosis, enhancescare of the patient, reduces the use of antibiotics, decreaseslength of stay in hospital, and can help to prevent furtherspread of infection. Over the past 20 years, vaccination policies,the HIV epidemic, altered sexual behaviour, and increasing travelhave altered the spectrum of causative agents. In this reviewwe outline the changing epidemiology, discuss key clinical topics,and illustrate how identification of the specific viral causeis beneficial. Neonatal meningitis may be a component of perinatalinfection and is not covered here.

Bacterial and viral meningitis . . . [Full text of this article]

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