Case 33: Aseptic meningitis in a 10 year old

Question 1

What is the likely cause of normal protein and glucose concentration with elevated polymorphs in the CSF?

Answer 1

Viral meningitis

Question 2

What would be the protein concentration in CSF if the infection were TB?

Answer 2

High

Question 3

What is a 10 year old patient’s prognosis when diagnosed with viral meningitis?

Answer 3

Generally good

Question 4

What 2 viruses commonly cause viral meningitis?

Answer 4

HSV and enteroviruses

Question 5

How can a virus be identified from cell culture?

Answer 5

By cytopathic effects (CPE) on the cultured cells

Question 6

What are the most common causes of meningitis?

Answer 6

Viruses

Question 7

If CSF was unavailable, would the isolation of a virus from another specimen be significant for diagnosis of enterovirus meningitis?

Answer 7

No!

Enteroviruses are found in the gut and typically don’t cause disease, so isolation from there may not be significant.