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Meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges). The most common causes of meningitis are viral infections that usually get better without treatment, however bacterial meningitis infections are extremely serious, and may result in death or brain damage, even if treated. Most viral meningitis is due to enteroviruses, which are viruses that also can cause intestinal illness.
Viral meningitis can be caused by herpes viruses, the same virus that can cause cold sores and genital herpes, people with cold sores or genital herpes, however, are not at a greater risk of developing herpes meningitis.
More recently, West Nile virus, spread by mosquito bites, has become a cause of viral meningitis in most of the United States. You cannot tell if you have bacterial or viral meningitis by how you feel, your healthcare provider must perform diagnostic tests.
Disclaimer: All content on this website is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. A Aseptic Meningitis in the Newborn and Young InfantA  This is a corrected version of the article that appeared in print. INTRODUCTION , Although encephalitis is a rare complication of herpes simplex virus (HSV) infection, HSV is The most common cause of nonepidemic, sporadic, focal acute encephalitis in the United States [1,2]. THUS, CNS disease OCCURS in approximately 50 percent of neonatal HSV infection With babies. It usually occurs in late summer and early fall and most often affects children and adults under the age of 30. You may also get dexamethasone, a type of steroid medicine, and you will be observed carefully to prevent serious problems such as hearing loss, seizures, and brain damage. Use of this website and the information contained herein does not create a doctor-patient relationship. Cerebrospinal fluid should be obtained (unless lumbar puncture is clinically contraindicated) to enable initial therapy to be planned. Symptoms to inquire about in the infant include poor feeding, lethargy or irritability, altered sleep pattern, seizures, rash, vomiting, diarrhea or respiratory difficulty.1A  Fever may or may not be present (Table 1). Patients should be hospitalized, and treatment with intravenous antibiotics should be started. Fortunately, there are alternative treatments that allow you to prevent and control herpes naturally.
DIAGNOSTIC STANDARD METHODS The clinical presentation does not distinguish herpes simplex encephalitis (HSE) from encephalitis Caused by other viruses: such as St. Limb pain, pale skin, and cold hands and feet often appear earlier than the rash with neck stiffness, dislike of bright lights, and confusion.
If they think you have meningitis, a lumbar puncture (spinal tap) may be done to remove a sample of spinal fluid (cerebrospinal fluid, or CSF) for testing. Viral meningitis is more common, and most people with this form of the illness get better in about 2 weeks. Always consult with your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.
Initial results of cerebrospinal fluid testing may not conclusively differentiate between aseptic and bacterial meningitis, and antimicrobial therapy for all likely organisms should be instituted until definitive culture results are available. To help identify the cause of meningitis, it is important to consider the season, the patient's exposure to ill persons and travel history, and typical infectious diseases that may be prevalent in the community at the time.2 In infants younger than three months of age, congenital and perinatal diseases may present with abnormal cerebrospinal fluid findings.


Although it usually presents as sepsis in the neonate, it can have a late-onset presentation as meningitis at one to 12 weeks of age.5 Escherichia coli and Listeria monocytogenes are other pathogens that cause meningitis in the newborn. Hearing should be assessed one to two months after discharge, using brainstem auditory evoked response testing. The administration of acyclovir you reduce the mortality from approximately 70 percent in untreated infection to 19 to 28 percent; however, neurologic impairment is common (44 to 62 percent) in Those Who Survive [3,4].
Louis (flavivirus), Eastern equine (togavirus), and Epstein-Barr virus (EBV), Mycobacterium tuberculosis or meningitis from [5] . Autoimmune disease and the effects of cancer can also cause encephalitis. Encephalitis is uncommon. Accessed March 10, 2011.Viral encephalitis - Healthcare CenterViral encephalitis Highlights. Comprehensive therapy, including antibacterial and antiviral agents, should continue until a cause is identified and more specific therapy is initiated, an etiology is excluded or the patient improves considerably and the course of antimicrobial therapy is completed. The mother should be questioned about any fever or complicating illness occurring during pregnancy or around the time of delivery. Although bacterial organisms are frequently associated with a more fulminant course, HSV and Enterovirus may also produce viral septic shock. Neuromuscular assessment at the time of discharge should be documented and periodically assessed on an outpatient basis to allow early detection of any deficiencies.
The elderly and infants are more vulnerable and may have a more severe case of the disease. Symptoms When the virus enters the bloodstream, it may cause inflammation of brain tissue and surrounding membranes. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact. Home treatment includes taking medicine for fever and pain, and drinking enough fluids to stay hydrated. Group B streptococcus is the most common bacterial etiologic agent in cases of meningitis that occur during the first month after birth.
Antibiotics should be administered until all bacterial cultures have been negative for at least 72 hours.
Learning disabilities, behavior disorders and speech delay, which can be difficult to diagnose in infants and young children, require close monitoring after discharge and at subsequent well-child visits.
Septicaemia is blood poisoning caused by the same germs and is the more life-threatening form of the disease. Encephalitis, an inflammation of the brain, is rare but can be caused by many different viruses. Etiologies of aseptic meningitis include viral infection, partially treated bacterial meningitis, congenital infections, drug reactions, postvaccination complications, systemic diseases and malignancy.
In adults, the infection is Usually Caused by HSV type 1 and May be due to primary infection or reactivation of latent infection. Long-term sequelae of meningitis include neuromuscular impairments, learning disabilities and hearing loss.
He had no cough, vomiting or diarrhea.The prenatal history was remarkable for maternal first-trimester primary genital herpes simplex virus (HSV) infection. Better results are Obtained With That measure tests HSV antigens or antibodies in the CSF; These tests are sensitivity and specificity Associated With rates of 75 to 85 percent and 60 to 90 percent, respectively [2]. Prompt diagnosis and treatment are essential to improved outcome.When a newborn or young infant presents with fever and lethargy or irritability, meningitis is a primary concern.


Bacterial meningitis has an incidence of about 20 to 100 cases per 100,000 live births during the newborn period.1 Aseptic meningitis is even more common.
It is acquired by intrapartum Usually Contact with infected maternal genital secretions, and is due to THEREFORE MOST Often HSV type 2. Other cases are severe, and permanent impairment or death is possible. The acute phase normally lasts for 1 - 2 weeks.
Although most types of aseptic meningitis do not cause serious sequelae, some types result in significant morbidity and mortality if not properly diagnosed and treated. She had not traveled out of the country and had no known exposure to ticks, cats or undercooked meat.
Some people may take several months to fully recover. Possible Complications Permanent brain damage may occur in severe cases of encephalitis.
He had no bulging fontanelle, rash, petechiae, vesicular lesions, hepatosplenomegaly or neurologic abnormalities.The cerebrospinal fluid showed a red blood cell count of 15 per mL and a white blood cell count of 1,295 per mL, with a differential of 1 percent neutrophils, 32 percent lymphocytes and 67 percent monocytes. Important physical findings include lethargy or irritability, fever or hypothermia, petechial, vesicular or macular skin rash, mucosal lesions, tachypnea or apnea1A  (Table 1). His peripheral complete blood cell (CBC) count was 13,600 per mL, with a differential of 32 percent neutrophils, 61 percent lymphocytes and 2 percent monocytes.Because of the patient's age and the maternal history of genital HSV infection, the infant was admitted to the hospital, and cefotaxime (Claforan), ampicillin and acyclovir (Zovirax) were administered. The child may be more irritable while being held than while lying still (paradoxic irritability).LABORATORY DATAThe most important test to perform when meningitis is suspected is the lumbar puncture. After bacterial cultures were negative for 72 hours, therapy with cefotaxime and ampicillin was discontinued. The cerebrospinal fluid should be tested for cell counts with differential, Gram stain, glucose determination, protein and bacterial cultures. After cerebrospinal fluid culture for HSV was negative for seven days and the polymerase chain reaction (PCR) test of the cerebrospinal fluid was negative, therapy with acyclovir was discontinued. PCR can provide same-day results for several viruses, including HSV, cytomegalovirus, human immunodeficiency virus (HIV) and the enteroviruses.3Other important laboratory values to obtain during the evaluation include a CBC and bacterial cultures of blood and urine. Occasionally, a computed tomographic (CT) scan or magnetic resonance imaging (MRI) is indicated to help identify causative agents.
Although cerebrospinal fluid values may help to differentiate bacterial from viral etiologies, culture is still the gold standard. Aseptic meningitis typically follows a shorter, more benign course than bacterial meningitis. Cerebrospinal fluid values for bacterial and aseptic meningitis may overlap, and all newborns and young infants should receive antibiotic therapy if cerebrospinal fluid values are abnormal or meningitis is suspected.
Approximately 40,000 infants born in the United States have cytomegalovirus infection, and 20 percent of these infants experience significant morbidity or mortality.13 A diagnosis of congenital syphilis should be considered in infants with the physical stigmata of syphilis or in those whose mothers have a known history of inadequately treated syphilis. Each year in the United States, about 3,000 infants are born with congenital toxoplasmosis. Most cases of toxoplasmosis are acquired through ingestion of undercooked meat or oocytes from cat feces.



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