Aseptic meningitis: Difference between revisions
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* Infectious |
* Infectious |
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** Viral |
** Viral |
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| − | *** EV-B species (includes Group B coxsackieviruses and echoviruses) are the most common cause of aseptic meningitis in both children and adults |
+ | *** [[Enterovirus]] 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 |
**** CV-B2 to CV-B5, E-6, E-6, E-9, E-11, E-13, E-16, E-18, E-30, and E-33 |
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| − | *** Herpes (especially HSV-2, as primary infection) |
+ | *** [[Herpes]] (especially HSV-2, as primary infection) |
| − | *** Varicella |
+ | *** [[Varicella]] |
| − | *** Mumps (encephalitis), measles (acute encephalitis) |
+ | *** [[Mumps]] (encephalitis), measles (acute encephalitis) |
| − | *** Arboviruses |
+ | *** [[Arboviruses]] |
| − | *** Lymphocytic choriomeningitis virus (LCMV) |
+ | *** [[Lymphocytic choriomeningitis virus]] (LCMV) |
| − | *** Acute HIV |
+ | *** Acute [[HIV]] |
| − | *** EBV, influenza, Colorado tick virus, rabies |
+ | *** [[EBV]], [[influenza]], [[Colorado tick virus]], [[rabies]] |
** Bacterial |
** Bacterial |
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| − | *** Leptospirosis |
+ | *** [[Leptospirosis]] |
| − | *** Lyme disease |
+ | *** [[Lyme disease]] |
| − | *** |
+ | *** [[Rickettsia species]] (before onset of fever) |
| − | *** Other causes of bacterial meningitis after antibiotics |
+ | *** Other causes of [[bacterial meningitis]] after antibiotics |
** Mycobacterial |
** Mycobacterial |
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** Fungal |
** Fungal |
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*** Azathioprine |
*** Azathioprine |
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*** NSAIDs |
*** NSAIDs |
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| − | *** |
+ | *** [[TMP-SMX]], [[amoxicillin]], [[isoniazid]] |
*** Allopurinol |
*** Allopurinol |
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Revision as of 16:17, 15 August 2019
Differential Diagnosis
- Infectious
- Viral
- Enterovirus 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
- Enterovirus EV-B species (includes Group B coxsackieviruses and echoviruses) are the most common cause of aseptic meningitis in both children and adults
- Bacterial
- Leptospirosis
- Lyme disease
- Rickettsia species (before onset of fever)
- Other causes of bacterial meningitis after antibiotics
- Mycobacterial
- Fungal
- Viral
- Non-infectious
- Systemic lupus erythematosus
- Drug-induced meningitis
- IVIg
- Azathioprine
- NSAIDs
- TMP-SMX, 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
