From the Guidelines
Aseptic meningitis is a viral inflammation of the meninges that typically resolves on its own without specific treatment, and management focuses on supportive care including rest, adequate hydration, and pain control with acetaminophen or NSAIDs. The diagnosis of aseptic meningitis involves lumbar puncture showing increased white blood cells with normal glucose and negative bacterial cultures, as noted in the study by 1. Key aspects of management include:
- Supportive care with rest and hydration
- Pain control with acetaminophen (500-1000mg every 6 hours) or NSAIDs like ibuprofen (400-600mg every 6-8 hours) for headache and fever, as recommended by 2
- Monitoring for severe symptoms such as persistent high fever, altered mental status, seizures, or severe headache, which require immediate medical attention
- Diagnosis typically involves lumbar puncture, as stated in the guideline by 3 Enteroviruses cause most cases of aseptic meningitis, particularly during summer and fall months, as mentioned in the study by 1. Unlike bacterial meningitis, aseptic meningitis generally has a benign course without long-term complications, though symptoms like headache, fatigue, and concentration difficulties may persist for weeks, as noted in the study by 2. Maintaining good hygiene practices, including handwashing and avoiding close contact with infected individuals, helps prevent transmission of the viruses that commonly cause this condition. It is essential to prioritize supportive care and monitor for severe symptoms, rather than relying on specific treatments, which have not shown proven benefit, as stated in the study by 2.
From the Research
Diagnosis of Aseptic Meningitis
- The diagnosis of aseptic meningitis is difficult and requires the exclusion of infectious etiologies 4
- Evaluation of the cerebrospinal fluid can confirm the diagnosis 5
- Diagnostic work up includes blood and cerebrospinal fluid (CSF) examination and serology for infectious meningitis 6
- The polymerase chain reaction is a rapid and accurate method for detection of microbial DNA in CSF 6
Symptoms of Aseptic Meningitis
- Symptoms typically include fever, neck stiffness, headache, confusion, nausea and vomiting 4
- Clinical manifestations include headache, fever, malaise, photophobia and meningeal signs 6
- Convulsions, neurological deficits and severe obtundation are rare except with certain non viral infectious meningitis 6
Treatment of Aseptic Meningitis
- Treatment of viral meningitis is generally supportive, and patients usually do well 5
- Other forms of aseptic meningitis may require drug treatment or removal of inciting medications 5
- The outcome of drug-induced aseptic meningitis is generally good, usually without long term sequelae 4
- Treatment is mainly supportive, except for the nonviral infectious etiology 6