Aseptic meningitis is an illness that appears similar to bacterial meningitis; however, bacteria do not grow in cultures of the fluid around the brain and spinal cord (cerebrospinal fluid).
There are many causes of aseptic meningitis, including:
About half of aseptic meningitis cases are caused by the coxsackie virus and echovirus, two members the enterovirus family. The rate of enteroviral infections increases in the summer and early fall. Enteroviruses are spread by hand-to-mouth contact and coughing. They also may be spread by contact with fecal matter.
Other viruses that cause this condition include:
Risk factors for aseptic meningitis include:
For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which a sample of spinal fluid (known as cerebrospinal fluid, or CSF) is taken for testing.
Tests may include:
Treatment is needed for fungal or mycobacterial causes of aseptic meningitis. Herpesvirus or varicella (chicken pox) virus may be treated with antiviral medicines. Treatment for non-infectious causes consists of pain medications and management of complications, if they occur.
No specific treatment is available for enteroviral aseptic meningitis.
Aseptic meningitis caused by a virus is usually a harmless disease. People usually recover fully 5 - 14 days after symptoms start.
Fatigue and light-headedness may last longer in some people.
An infection of the brain (encephalitis) may develop, though this is rare. The infection may last much longer in a person with a depressed immune system.
Call your health care provider if you have symptoms of aseptic meningitis.
To reduce the risk of developing an infection that can become meningitis:
Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsever; 2007: chap 437.