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Aseptic meningitis: a foundation review

Hazim Allos1, Rodrigo Hasbun

  • 1Department of Medicine, Section of Infectious Disease, McGovern Medical School, UT Health Science Center, Houston, Texas, USA.

Current Opinion in Infectious Diseases
|March 28, 2025
PubMed
Abstract

Insights

Advanced molecular diagnostics are improving the identification of pathogens causing aseptic meningitis (inflammation of the membranes surrounding the brain and spinal cord). This leads to better patient outcomes and reduced healthcare costs by enabling earlier, targeted treatments.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Aseptic meningitis presents with diverse infectious and non-infectious causes.
  • Over 50% of aseptic meningitis cases lack an identified etiology.
  • Distinguishing bacterial from non-bacterial meningitis is a clinical challenge.

Purpose of the Study:

  • To review diagnostic and management strategies for aseptic meningitis.
  • To explore the impact of advanced molecular diagnostics on clinical practice.
  • To highlight the importance of identifying causative agents for improved patient care.

Main Methods:

  • Comprehensive literature review of aseptic meningitis.
  • Analysis of advanced molecular diagnostic techniques (e.g., multiplex PCR, metagenomic sequencing).
  • Evaluation of emerging diagnostic algorithms and clinical models.

Main Results:

  • Advanced molecular diagnostics significantly improve pathogen identification in aseptic meningitis.
  • Enteroviruses are the most common cause, but other pathogens (Herpesviridae, arboviruses, fungi, spirochetes) are also implicated.
  • New diagnostic tools aid in differentiating bacterial from viral meningitis, reducing unnecessary antibiotic use.

Conclusions:

  • Advancements in diagnostic technology enable earlier pathogen detection, enhancing patient outcomes and reducing costs.
  • Timely and accurate diagnostics are crucial for effective aseptic meningitis management.
  • Increased awareness of non-infectious etiologies is vital for comprehensive patient care.
Keywords:
advanced molecular diagnosticsaseptic meningitiscerebrospinal fluid analysisinfectious and noninfectious etiologiesviral and bacterial differentiation

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