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[Acute aseptic meningitis in adults. Retrospective study of 32 cases]

M Pavic1, D Rabar, Y Amah

  • 1Service de médecine interne, HIA Desgenettes, Lyon. m.pavic@chello.fr

Presse Medicale (Paris, France : 1983)
|December 23, 2004
PubMed
Abstract

Insights

This study analyzed acute aseptic meningitis (AAM) cases, finding Enterovirus as a frequent cause. Early identification can help rapidly withdraw anti-infectious treatments and avoid unnecessary lumbar punctures.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Acute aseptic meningitis (AAM) is characterized by sterile cerebrospinal fluid (CSF) with elevated leucocytes and a neutrophilic predominance.
  • Understanding AAM characteristics is crucial for appropriate initial management and treatment decisions.

Purpose of the Study:

  • To analyze the clinical characteristics, initial management, and aetiologies of acute aseptic meningitis (AAM).
  • To evaluate the necessity of lumbar puncture and the progression of AAM cases.
  • To assess the role of specific viral investigations in guiding treatment decisions.

Main Methods:

  • Retrospective analysis of 32 AAM cases diagnosed between 1996 and 2003 in internal medicine departments.
  • Inclusion criteria required sterile CSF with >10 leucocytes/mm³ and ≥30% neutrophils.
  • Data collected included patient demographics, symptoms, CSF analysis, imaging, treatment, and outcomes.

Main Results:

  • The study included 32 patients (mean age 32.6 years, 59% male) with AAM.
  • Fever and viral syndrome were common preceding symptoms; Enterovirus was detected in 9/20 cases via PCR.
  • Most patients (87.5%) showed favorable outcomes by Day 3, with a mean hospital stay of 8.3 days; antibiotic/antiviral treatment was initiated in most cases.

Conclusions:

  • Enterovirus is a significant aetiology of AAM, necessitating specific diagnostic investigations.
  • Early identification of Enterovirus can facilitate the rapid discontinuation of empirical anti-infectious treatments.
  • This approach may help avoid unnecessary interventions, such as repeat lumbar punctures.

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