Meningitis is inflammation of meninges the membrane that covers brain and spinal cord. Aseptic meningitis is a term used when inflammation of meninges is caused due to reasons other than pus producing bacteria. Although virus infection is a common and major cause of aseptic meningitis, many other non bacterial etiologies are also responsible for this disease.
Clinical manifestation of aseptic meningitis is similar to bacterial meningitis, but the symptoms are mild and subdued. Headache, fever, vomiting, stiff neck, are the usual symptoms of aseptic meningitis. The course of aseptic meningitis is self limited and large numbers of patients recover without any specific therapy.
What Are The Causes Of Aseptic Meningitis?
Aseptic meningitis is the most common cause for inflammation of meninges. Majority of cases are caused due to viral infection. All age group are susceptible to it, but the disease is more common in children and people below the age of 30.
Viruses that are known to cause aseptic meningitis are those that are responsible for viral diseases such as polio, chickenpox, mumps, measles, herpes simplex, HIV, influenza and Epstein-Barr disease. Infection with these viruses in US usually occurs in the months of summer and early fall.
The spread of virus can be through direct contact with droplets released in cough and sneeze or saliva. Spread through fecal matter or blood can also occur as in case of HIV, herpes, and rabies virus. The risk of aseptic viral meningitis increases in people who have recently suffered from viral disease, live in crowded places or have suppressed immunity as in HIV and diabetes.
Rarely, aside from viral infection, some other pathogens can also lead to aseptic meningitis. This includes fungal infection, parasitic infection, certain medicines such as NSAIDs, intravenous immunoglobulin, malignancy and systemic disease such as rheumatoid arthritis, Kawasaki disease, sarcoidosis etc.
Signs And Symptoms Of Aseptic Meningitis
The symptoms of aseptic meningitis may depend on the causative virus or the condition that is responsible for the disease. Common symptoms are:
- Vomiting and nausea
- Loss of appetite
- Stiffness of neck
- Muscle pain
- Sore throat
- Pain in abdomen
- Headache which worsens by turning the neck.
- Sensitivity to light (photo-phobia).
- Altered consciousness in the form of drowsiness and confusion.
- Increased irritability and crying spells in children.
In most cases aseptic meningitis caused due to viral infection is mild in its course. It is often transient and the patient may not know that he had aseptic meningitis.
Diagnosis Of Aseptic Meningitis
Aseptic meningitis although mild, needs medical assessment. Often it is difficult to clinically conclude the type of meningitis during its prodromal phase. Physician may recommend certain tests to determine the type of meningitis. Blood routine tests are usually normal.
He may perform lumbar puncture to remove small amount of CSF (cerebrospinal fluid). He will send the fluid in laboratory for biochemical and microscopic examination which helps to determine whether the condition is aseptic meningitis or bacterial meningitis. Additionally some patients are also recommended X-ray and CT scan of brain.
Treatment Guidelines For Aseptic Meningitis
Many patients suffering from aseptic meningitis can be treated at home. Only some patients with severe symptoms may need hospitalization. There is no specific therapy for viral pathogens. The only treatment that a patient needs is supportive which include medicines to control fever, vomiting, body ache and headache.
Maintaining fluid and electrolyte balance in the body is important due to fluid loss in fever and vomiting. Patient is therefore advised to drink fluid as often as he can. In certain cases anti viral therapy is helpful if the disease is caused due to herpes virus, and HIV infection.
Anti-fungal medications may be necessary if the underlying causative pathogen is fungus. Whenever bacterial meningitis is suspected, an empirical antibiotic is started after obtaining the CSF for laboratory examination.
Patients suffering from aseptic meningitis usually recover within one or two weeks without any complications.