Clinical review of viral meningitis

BMJ 2008;336:36-40 (5 January). Clinical review
by: Sarah A E Logan, specialist registrar, Eithne MacMahon, consultant Infection and Immunology:

* Bacterial and viral meningitis cannot reliably be differentiated clinically, and all suspected cases should be referred to hospital
* Viral meningitis is most common in young children; the incidence decreases with age
* Enteroviruses are the most common cause at all ages
* Although most cases are self limiting, morbidity may be considerable
* Herpes simplex virus causes viral meningitis, which may recur
* Genital herpes infection may be acquired from a partner after many years within a monogamous relationship
* Meningitis is a feature of HIV seroconversion
* In the absence of associated encephalitis, the prognosis is usually good