VIRAL MENINGITIS

Question 1

The most common cause of viral meningitis?

Answer 1

Enteroviruses (EV)

• Enteroviruses (EV) are the most common cause of viral meningitis, accounting for >85% of cases
• CSF reverse transcriptase PCR (RT-PCR) is the diagnostic procedure of choice and is both sensitive (>95%) and specific (>100%).
• Treatment is supportive, and patients usually recover without sequelae.

Question 2

The major cause of viral meningitis in adults, and overall, the second most important cause of viral meningitis?

Answer 2

HSV meningitis

Question 3

What is the most common cause of HSV strain that is implicated in adult HSV meningitis?

Answer 3

HSV-2

• In adults, the majority of cases of uncomplicated meningitis are due to HSV-2, whereas HSV-1 is responsible for 90% of cases of HSV encephalitis

Question 4

Therapeutic regimen for viral meningitis?

Answer 4

Oral or IV acyclovir

*IV Acyclovir (15–30 mg/kg per day in three divided doses) followed by an oral drug such as Acyclovir (800 mg 5x daily), Famciclovir (500 mg TID), or Valacyclovir (1000 mg TID) for a total course of 7–14 days

Question 5

TRUE OR FALSE: In adults, the prognosis for full recovery from viral meningitis is POOR?

Answer 5

FALSE.
In adults, the prognosis for full recovery from viral meningitis is EXCELLENT

Question 6

Presence of_________ in the CSF or peripheral blood is suggestive of EBV infection

Answer 6

Atypical lymphocytes

• EBV infections may also produce aseptic meningitis, with or without associated infectious mononucleosis.

Question 7

_____ meningitis should be suspected in the presence of concurrent chickenpox or shingles.

Answer 7

VZV meningitis

Question 8

The single most important method for diagnosing CNS viral infections

Answer 8

Amplification of viral-specific DNA or RNA from CSF using PCR amplification

Question 9

TRUE OR FALSE: The sensitivity of CSF cultures for the diagnosis of viral meningitis and encephalitis is generally POOR.

Answer 9

TRUE