Aseptic meningitis: Difference between revisions

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= Differential Diagnosis =
= Aseptic meningitis =

== Differential Diagnosis ==


* Infectious
* Infectious
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*** Allopurinol
*** Allopurinol


== Investigations ==
= Investigations =


* Enterovirus
* Enterovirus
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* Syphilis screening EIA
* Syphilis screening EIA
* HIV screen
* HIV screen

[[Category:CNS infections]]

Revision as of 17:31, 13 August 2019

Differential Diagnosis

  • Infectious
    • Viral
      • EV-B species (includes Group B coxsackieviruses and echoviruses) are the most common cause of aseptic meningitis in both children and adults
        • CV-B2 to CV-B5, E-6, E-6, E-9, E-11, E-13, E-16, E-18, E-30, and E-33
      • Herpes (especially HSV-2, as primary infection)
      • Varicella
      • Mumps (encephalitis), measles (acute encephalitis)
      • Arboviruses
      • Lymphocytic choriomeningitis virus (LCMV)
      • Acute HIV
      • EBV, influenza, Colorado tick virus, rabies
    • Bacterial
      • Leptospirosis
      • Lyme disease
      • Rickettsioses (before onset of fever)
      • Other causes of bacterial meningitis after antibiotics
    • Mycobacterial
    • Fungal
  • Non-infectious
    • Systemic lupus erythematosus
    • Drug-induced meningitis
      • IVIg
      • Azathioprine
      • NSAIDs
      • Septra, amoxicillin, isoniazid
      • Allopurinol

Investigations

  • Enterovirus
    • Usually positive PCR of CSF
    • Can look for enterovirus in stool, nasopharyngeal, and throat, as well as conjunctiva if there is conjunctivitis
    • Persists in stool for several weeks, but less specific
    • NP preferred over throat
  • Parechovirus PCR if very young child or immunocompromised
  • West Nile IgM/IgG/PCR from CSF and blood
  • Syphilis screening EIA
  • HIV screen