Abstract
The term aseptic meningitis encompasses all types of inflammations of the brain meninges other than that caused by pus producing organisms. It is usually a benign illness. Etiology of aseptic meningitis is very wide and includes many infections—both viral and non viral, drugs, malignancy and systemic illness. The most common cause is viral infection and enteroviruses—Coxsackie and ECHO viruses account for more than half of all cases. Clinical manifestations include headache, fever, malaise, photophobia and meningeal signs. Convulsions, neurological deficits and severe obtundation are rare except with certain non viral infectious meningitis. Diagnostic work up includes blood and cerebrospinal fluid (CSF) examination and serology for infectious meningitis. The polymerase chain reaction is a rapid and accurate method for detection of microbial DNA in CSF. Treatment is mainly supportive except for the nonviral infectious etiology.
Similar content being viewed by others
References
Krugman S, Katz SL, Gerston AA, Wilfert C.Aseptic Meningitis in Infectious Diseases of Children. 8th edn. CV Mosby Co, Toronto, 1985; 167–173.
Hammer SM, Connolly KJ. Viral aseptic meningitis in the United States: Clinical features, viral etiologies and differential diagnosis.Curr Clin Top Infect Dis 1992; 12: 1–25.
Centre for Disease Control Morbidity & Mortality Weekly Report 2003: 52 (32); 761–764.
Tee WS, Choong CT, Lui RV, Ling AE. Aseptic meningitis in children: The Singapore experience.Ann Acad Med Singapore 2002; 31 (6); 756–760.
Middlekamp JN. Aseptic meningitis & viral meningitis. In Feigin, Cherry, eds.Textbook of Pediatric Infectious Disease. Feigin & Cherry WB Saunders Co, 1981; 319–324.
Prober CG. Infections of the Central Nervous System. Behrmann, Kleigman & Jenson, eds.Nelson Textbook of Pediatrics; 16th edn. WB Saunders Co, 2000; 713–716.
Rotbart HP. Enteroviral infections of the central nervous system.Clin Infect Dis 1995: 20(4); 971–981.
Shukla PC, Ramachandran T. Aseptic Meningitis. Emedicine Article 23rd May 2002.
Connolly KJ, Hammer SM. The acute aseptic meningitis syndrome.Infect Dis Clin North Am 1990; 4(4); 599–622.
Dalton M, Newton RW. Aseptic meningitis.Dev Med Child Neurol 1991; 33(5); 446–451.
Muir P, van Loon AM. Enterovirus infections of the central nervous system.Intervirology 1997; 40 (2): 153–166.
Deshpande JM, Nadkarni SS, Francis PP. Enterovirus 71 isolated from a case of acute flaccid paralysis in India represents a new genotype.Curr Sci 2003; 85(10): 1350–1353.
Gabudza DH. Neurological disorders associated with HIV infection and AIDS.Am Fam Physician 1995; 51(2): 387–398.
Medical Research Council: Tuberculosis survey of England & Wales 1978/1979. HMSO London 1980
Kumar R, Singh SN, Kohli N. A diagnostic rule for tuberculous meningitis.Arch Dis Child 1999; 81: 221–224.
Handa R, Wali JP, Singh S, Aggarwal P. A propective study of dengue arthritis in north India.Indian J Med Res 1999; 110: 107–9.
Tuerlinckx D, Bodart E, Garrino MG, de Bilderling G. Clinical data and cerebrospinal fluid findings in Lyme meningitis versus aspectic meningitis.Eur J Pediatr 2003; 162 (3); 150–153.
Kochar DK, Agarwal N, Jain N, Sharma BV, Rastogi A, Meena CB. Clinical profile of neurobrucellosis—a report of 12 cases from Bikaner (north west India).J Assoc Phys India 2000; 48 (4): 376–380.
Shah I, Warke S, Deshmukh CT, Kamat JR. Leptospirosis—an underdiagnosed clinical condition.J Postgrad Med 1999; 45: 93–94.
Moris G, Garcia-Monco JC. The challenge of drug induced aseptic meningitis.Arch Intern Med 1999; 159 (11); 1185–1194.
Marinac JS. Drug and chemical induced aseptic meningitis: a review of the literature.Ann Pharmacother 1992; 26 (6): 813–822.
Shapiro WR, Young DF. Neurological complications of antineoplastic therapy.Acta Neurol Scand Suppl 1984; 100: 125–132.
Min DI, Monaco AP. Complications associated with immunosuppressive therapy and their management.Pharmacotherapy 1991; 11(5): 119S-125S.
Nydegger UE, Sturzenegger M. Adverse effects of immunoglobulin therapy.Drug Saf 1999; 21 (3): 171–185.
Alloway JA, Mitchell SR. Sulfasalazine neurotoxicity: a report of aseptic meningitis and a review of the literature.J Rheumatol 1993; 20(2): 409–411.
Chaudhry HJ, Cunha BA. Drug induced aseptic meningitis. Diagnosis leads to quick resolution.Postgrad Med 1991; 90 (7): 65–70.
Dang Ct, Riley DK. Aseptic meningitis secondary to carbamazepine therapy.Clin Infect Dis 1996; 22(4): 729–730.
Hoppmann RA, Peden JG, Ober SK. Central nervous system side effects of nonsteroidal anti-inflammatory drugs: Aseptic meningitis, psychosis and cognitive dysfunction.Arch Intern Med 1991; 151 (7): 1309–1313.
Wittmann A, Wooten GF. Amoxicillin induced aseptic meningitis.Neurology 2001; 57 (9): 1734.
Hoffmann MA, Valderrama E, Fuchs Aet al. Leukemic meningitis in B cell prolymphocytic leukemia.Cancer 1995; 75(5): 1100–1103.
Miller K, Budke H, Orazi A. Leukemic meningitis complicating early stage chronic lymphocytic leukemia.Arch Path Lab Med 1997; 121(5): 524–527.
Moots PL, Harrison MB, Vandenburg SR. Prolonged survival in carcinomatous meningitis associated with breast cancer.South Med J 1995; 88(3): 357–362.
Kennedy C. Acute viral encephalitis in childhood.BMJ 1995; 310: 139–140.
Roos KL. Pearls and pitfalls in the diagnosis and management of central nervous system infectious disease.Semin Neurol 1998; 18 (2): 185–196.
Hosoya M, Sato M, Honzumi K, Katayose M, Sakuma Het al. Application of polymerase chain reaction and subsequent phylogenetic analysis to the diagnosis of enteroviral infection in the central nervous system.J Clin Virol 2002; 25 (Suppl 1): S27-S38.
Stellrecht KA, Harding I, Woron AM, Lepow ML, Venezia RA. The impact of an enteroviral RT-PCR assay on the diagnosis of aseptic meningitis and patient management.J Clin Virol 2002: 25 (Suppl 1): S19-S26.
Kumar R, Kohli N, Thavnani H, Kumar A, Sharma B. Value of CT scan in the diagnosis of meningitis.Indian Pediatr 1996; 33: 465–468.
Nigrovic LE, Kuppermann N, Malley R. Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post hemophilus influenzae era.Pediatrics 2002; 110 (4): 712–719.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kumar, R. Aseptic meningitis: Diagnosis and management. Indian J Pediatr 72, 57–63 (2005). https://doi.org/10.1007/BF02760582
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02760582