Viral meningitis is an acute inflammatory disease of the meninges caused by a virus, in which patients often present with fever, headache, and meningeal irritation. The course of the disease is short, it is a self-limiting disease, and with the symptomatic and supportive support of doctors, most patients have a good prognosis.
It is a viral infectious disease that is mainly caused by enteroviruses.
Essential**. Enterovirus.
85% and 95% of viral meningitis is caused by enteroviruses, including poliovirus, coxsackievirus A and B, echovirus, etc.
Enteroviruses can be transmitted through the fecal-oral route, contact, and respiratory secretions.
Most enteroviruses initially infect the lower gastrointestinal tract, and then enteroviruses enter the bloodstream through the intestine to produce viremia, and then invade the meninges through the choroid plexus, eventually causing inflammation of the meninges, resulting in viral meningitis.
Other. Other viruses that can cause viral meningitis include mumps virus, herpes simplex virus, and adenovirus.
Predisposing factors. Exertion, rain, cold, and immunocompromise are predisposing factors.
02. Symptoms.
Most of them have an acute onset. Patients mainly present with fever, headache, photophobia, myalgia, nausea, vomiting, loss of appetite, diarrhea, malaise, etc., and may have meningeal irritation.
Typical symptoms. The most common presentations are fever, headache, and meningeal irritation (e.g., neck rigidity). However, patients may have different symptoms depending on their age, immune status, and type of virus they are infected with.
In infants, symptoms such as fever, vomiting, rash, irritability, irritability, irritability, lack of eating, drowsiness, and poor mental health can be manifested in infants, while cervical rigidity is mild or even absent due to patent fontanelle; In general children or ** patients, children may present with fever, headache, neck stiffness, photophobia, drowsiness or difficulty waking up, nausea, irritability, vomiting, loss of appetite, fatigue and drowsiness.
03. Relevant inspections.
A doctor's examination. During the physical examination, the doctor will pay special attention to the relevant examination of the nervous system, and pay attention to whether the patient has fever, rash, neck stiffness, nerve damage, etc.
Laboratory tests.
Complete blood count. An increase in the proportion of peripheral blood lymphocytes or monocytes may be associated with viral infection.
Virological tests.
Blood, stool, and throat swabs are tested for the virus that causes meningitis, and a sample can be taken for laboratory testing to aid in diagnosis.
Imaging tests.
CT or magnetic resonance imaging (MRI) of the brain: may be seen for parenchymal abnormalities, and meningeal enhancement may be seen on contrast-enhanced scan. EEG:
An electroencephalogram (EEG) records nerve firing in the brain. If concomitant encephalitis is suspected, the doctor will recommend an electroencephalogram.
Special examinations. Lumbar puncture and cerebrospinal fluid analysis: Perform a lumbar puncture except in patients with contraindications. Analysis of cerebrospinal fluid (CSF) may reveal normal or elevated pressure;The white blood cell count is normal or elevated, up to (10 1000) x 106 L;Polymorphonuclear cells predominate in the early stage, and lymphocytes predominate after 8-48 hours. Protein may be mildly elevated, and sugar and chloride levels are normal.
The disease** is symptomatic, supportive** and prevention and treatment of complications.
Acute phase**.
Depending on intracranial pressure, dehydration with medications such as mannitol may be required**;Depending on respiratory and circulatory involvement, respiratory support, circulatory support** may be required.
Drugs**. Due to individual differences, there is no absolute best, fastest and most effective medication, except for commonly used over-the-counter drugs, the most appropriate drug should be selected under the guidance of a doctor in full combination with individual circumstances.
Relieve pain. Pain medications may be used for severe headaches.
Anti-epileptic. Antiepileptic drugs such as carbamazepine, phenytoin, etc. can be used for seizures.
Reduces cerebral edema.
Cerebral edema is uncommon in viral meningitis, and doctors give mannitol as appropriate if necessary.
Antiviral. Antiviral** can significantly shorten the duration of the disease and alleviate symptoms, and the drugs currently used clinically or experimentally for enterovirus infection include immune serum globulin and the anti-microRNA virus drug pleconalib.
Surgery**. Surgery is generally not required for this condition**.
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