viral meningitis.pptx

8/18/2019 VIRAL MENINGITIS.pptx

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Viral MeningitisDakshnamoorthy Vythinathan


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INTRODUCTION

Meningitis is infammation o the meninges, maniest bycerebrospinal fuid (CSF) pleocytosis

ncephalitis is infammation o the brain parenchyma thatproduces neurologic dysunction

Myelitis ! Myelitis is infammation o the spinal cord,maniest by faccid paralysis and reduced or absentrefe"es


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OVERVIEW

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EPIDEMIOLOGY

Viral meningitis accounts or appro"imately 01,222 to30,222 hospitali4ations each year in the -nited States,

5ecting mainly inants younger than one year andchildren 6 to 72 years o age

ntero8irus being the most common cause 9ith seasonalpattern


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PATHOGENESIS

Secondary 8iremia

.each CS Multiplication

#rimary Viremia

%nset o illness %rgan seeding

#.$M. V$.& $FC*$%

'$ mucosa.espiratory

mucosa


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CONT’

*ransendothelial passage o the 8irus occurs in 8essels o thechoroid ple"us, meninges, or cerebrum:;


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CLINICAL FEATURES

#resence or absence o normal brainunction distinguishes meningitis

rom encephalitisCertain 8iruses usually cause

isolated meningitis or isolatedencephalitis

&ess discrete maniestations CSinection meningoencephalitis orencephalomyelitis

$mportant to try to distinguish


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CONT’

Vary 9ith age, immune status, andetiologic agent

%ten are less se8ere than bacterialmeningtis

eonates > non;speci?c symptoms%lder children > acute onset o

e8er, headache, nausea, 8omiting,sti5 neck, and photophobia


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CONT’


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DIAGNOSING

+istory:; *he presence o classic symptoms Symptoms o encephalitis Symptoms associated 9ith speci?c 8iruses

#receding illness $mmuni4ation history %utbreaks o human or animal disease


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CONT’

"aminationSigns o meningeal infammation

(nuchal rigidity, /ernig and


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CONT’

$maging

Computed tomography (C*) o thehead is necessary beore lumbarpuncture in patients 9ith signs orsymptoms o $C#

$ndications > ltered mental status ,

immune de?ciency, papilledema,CS trauma, ocal neurologic de?cit@

euroimaging: Meningitis or

ncephalitisA


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CONT’

&aboratory *est


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DIFFERENTIALDIAGNOSIS


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TREATMENT

+ospitali4ation *he diagnosis o 8iral meningitis reLuires

negati8e CSF culture or routinebacterial pathogens and positi8eidenti?cation o a 8iral pathogen in theCSF or other patient samples@

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PROGNOSIS

Most children 9ith 8iral meningitis reco8er completely@ Some may complain o se8eral 9eeks o atigue, irritability,

decreased concentration, muscle 9eakness and spasm,and incoordination ater the acute illness


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PREVENTION

+ygieneVaccine

#ersonal protection $nection Control


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TA"E HOME POINTS

$n children, 8iral meningitis mainly a5ects inants youngerthan one year and children 6 to 72 years o age

ntero8iruses are the most common cause o 8iralmeningitis

*he maniestations o 8iral meningitis are generally similarto those o bacterial meningitis but are usually less se8ere


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CONT’

Children 9ho are suspected o ha8ing meningitis should betreated as i they ha8e bacterial meningitis until bacterialmeningitis has been e"cluded

#ro8isional diagnosis is one o se8eral considerations in the

initial management mpiric therapy (8iral or bacterial) Speci?c therapy Follo9;up (SeLualae)


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REFERENCE

Cecilia Di #entima, MD Viralmeningitis: pidemiology,

pathogenesis, and etiology inchildren -ptodate@com@, 0273Cecilia Di #entima, MD Viral

meningitis: Clinical eatures anddiagnosis in children -ptodate@com@,0273

Cecilia Di #entima, MD Viral

meningitis: Management prognosis

viral meningitis.pptx

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