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The acute aseptic meningitis syndrome.

K J Connolly1, S M Hammer

  • 1Harvard Medical School, Boston, Massachusetts.

Infectious Disease Clinics of North America
|December 1, 1990
PubMed
Summary

Acute aseptic meningitis presents a diagnostic challenge. While viruses like enteroviruses are common, emerging pathogens and treatable mimics require careful clinical evaluation for favorable outcomes.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Acute aseptic meningitis syndrome poses diagnostic difficulties for clinicians.
  • Viruses, particularly nonpolio enteroviruses, are the primary cause, though other infectious and noninfectious etiologies exist.
  • Vaccine-preventable diseases like polio and mumps meningitis have decreased, shifting focus to other pathogens.

Purpose of the Study:

  • To highlight the diagnostic challenges in acute aseptic meningitis.
  • To review the spectrum of etiologies, including classic viral agents and emerging pathogens.
  • To emphasize the importance of considering treatable mimics and employing a rational diagnostic approach.

Main Methods:

  • Literature review of infectious and noninfectious causes of aseptic meningitis.
  • Discussion of classic and emerging pathogens.
  • Emphasis on clinical presentation and diagnostic strategies.

Main Results:

  • Nonpolio enteroviruses remain the most common viral cause.
  • Human immunodeficiency virus and Borna virus burgdorferi are increasingly recognized etiologies.
  • Conditions like fungal or mycobacterial meningitis and herpes simplex encephalitis can mimic aseptic meningitis.

Conclusions:

  • A systematic clinical approach and judicious laboratory testing are crucial for diagnosing aseptic meningitis.
  • Early and accurate diagnosis is essential for effective management and improved patient outcomes.
  • Clinicians must remain vigilant for both common viral and less common, treatable causes of aseptic meningitis.

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