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Aseptic meningitis

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Definition:

Aseptic meningitis is an illness characterized by headache, fever, and inflammation of the lining of the brain (meninges). Although it looks like bacterial meningitis, bacteria do not grow in cultures of the cerebrospinal fluid (fluid around the brain and spinal cord).

Alternative Names:

Sterile meningitis

Causes, incidence, and risk factors:

With aseptic meningitis a person has signs and symptoms of meningitis, but bacteria do not grow in culture. Many different things can cause aseptic meningitis including viruses, fungi, tuberculosis, some medications, and infections near the brain or spinal cord, such as epidural abscesses.

Coxsackie virus and echovirus, two members of a family of viruses called enteroviruses, account for about half the cases of aseptic meningitis. Other enteroviruses, herpes viruses, and mumps are additional causes. The rate of these enteroviral infections increases in the summer and early fall.

West Nile virus is a cause of aseptic meningitis that has recently spread across the United States. Usually, West Nile virus causes a self-limited (gets better on its own, without treatment) meningitis. Infrequently, it causes a more severe illness, which may include encephalitis (inflammation in the actual brain tissue) or paralysis similar to that seen in polio. These severe forms usually occur in elderly people or people with lowered immunity.

Enteroviruses are spread by hand-to-mouth contact and coughing. To a lesser extent, they also spread by contact with fecal matter. Mumps is spread by coughing or contact with secretions from the mouth and throat, with increased incidence in the spring.

Herpesvirus, both type 1 ( herpes simplex or herpes labialis) and type 2 ( genital herpes ) can cause meningitis in children, especially infants. Chicken pox can also cause aseptic meningitis. Rabies virus causes inflammation of both the brain and meninges (meningoencephalitis). HIV can cause aseptic meningitis, especially soon after exposure (acute HIV syndrome).

Some fungi and mycobacteria can cause aseptic meningitis, although this is much less common. Certain medications can also cause aseptic meningitis, including antibiotics and some over-the-counter anti-inflammatory medications.

Risk factors for aseptic meningitis include exposure to someone with a recent viral infection, exposure to children in a day care setting, being a health care worker, or having a suppressed immune system .

• Review Date: 9/6/2006
• Reviewed By: Hilary M. Babcock, M.D., Medical Director of Occupational Infection Control, Barnes-Jewish and St. Louis Children's Hospitals; Instructor of Medicine, Infectious Disease Division, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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