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Viral meningitis: definition and causes
Meningitis is an inflammation of the meninges, thin membranes that surround and protect the brain and spinal cord (which make up the central nervous system). Most of the time related to a viral, bacterial, parasitic or even fungal infection, meningitis is manifested in particular by an excess of cerebrospinal fluid, which increases intracranial pressure and causes various symptoms.
Depending on the germ in question, there are therefore different types of meningitis, including bacterial meningitis, which is by far the most serious.
Viral meningitis, on the other hand, can be caused by several types of viruses, although most are due to an enterovirus, such as echovirus, coxsackie viruses (note that type A is also responsible for foot-hand-mouth syndrome) or polioviruses (agents responsible for poliomyelitis).
Other viruses can cause viral meningitis, such as those responsible for:
- chickenpox or shingles;
- measles ;
- rubella ;
- mumps;
- HIV;
- infectious mononucleosis;
- herpes.
Note that, in fact, vaccines against measles, mumps, rubella and polio prevent cases of viral meningitis linked to these pathologies. A number of viruses that can cause meningitis are affected by compulsory vaccination, which includes 11 pathologies.
Meningeal syndrome dominates
In the case of viral meningitis, the meningeal syndrome, a sign of inflammation of the meninges, is dominant. The major symptoms are as follows:
- headache (headache);
- neck stiffness ;
- photophobia (sensitivity to light);
- nausea and / or vomiting.
Unlike bacterial meningitis, the infectious syndrome, characterized among other things by high fever, is less marked, although present at least initially.
Note that the virus in question can then or at the same time infect other organs, and lead to a runny nose, sore throat, earache, cough, rash or even breathing difficulties.
Unspecific signs in infants or babies
Attention, in the baby (newborn or even infant), the symptoms can be confused with those of another pathology or of the viral disease which degenerated into meningitis.
Therefore, it is a matter of being attentive and vigilant in the face of the appearance of a strong fever, a lack of appetite, an apathetic state or even disturbances of consciousness, a gray complexion, convulsions, a lack of reaction of the baby or incessant crying. The baby may also have a bulging upper head fontanel due to the excess cerebrospinal fluid resulting from meningitis.
A lumbar puncture to confirm the diagnosis
The viral origin can only be confirmed or ruled out in favor of bacterial meningitis after sampling of the cerebrospinal fluid thanks to a lumbar puncture, and analysis of the sample. Note that the absence ofskin rash (purpura fulminans, life-threatening emergency sign of the advanced stage of meningococcal meningitis) may already guide the diagnosis towards viral meningitis, as can a rather clear cerebrospinal fluid.
Sometimes, especially in children or babies and if the symptoms are worrying, an antibiotic treatment is prescribed urgently while awaiting the results of the analysis of the cerebrospinal fluid, to limit the consequences if it turns out to be It is a bacterial meningitis.
The transmission of viral meningitis depends on the virus involved.
In the case of enteroviruses, which represent the majority of viral meningitis, transmission occurs mainly through close contact with an infected person, via nasopharyngeal secretions, in other words droplets of saliva (postilions, coughs, sharing of contaminated objects). Kissing and close contact should therefore be avoided so that the patient avoids transmitting the virus to his relatives.
Transmission can also take place via the bloodstream, from an infectious site located elsewhere in the body, especially in the case of mumps, chickenpox or shingles, or rubella. The child will first suffer from this type of highly contagious disease before it evolves into viral meningitis.
Le contact with contaminated stool from an infected person can also lead to contamination, which is why it is recommended to wash your hands well when changing a baby with meningitis, and to disinfect the toilets regularly (or to reserve individual toilets) if an adult or child in the family suffers from viral meningitis.
If viral meningitis is caused by chikungunya, Zika or West Nile virus, transmission takes place from a bite of the tiger mosquito carrying the virus.
Finally, if the viral meningitis is linked to HIV, the infection occurred through sex or sharing contaminated needles.
Although it can be impressive given its symptoms, viral meningitis is generally benign. In a person without immune deficiencies, healing usually occurs without sequelae after a few days, ten at most. Bed rest and painkillers are often enough for the patient to recover.
Since viral meningitis is caused by a virus and not a bacterium, it is not necessary to prescribe antibiotics (at least once the diagnosis is certified). Treatment is mainly symptomatic, and therefore consists of relieving symptoms caused by meningitis, such as fever or headache.
Only severe forms of viral meningitis, in particular meningoencephalitis linked to herpes, require the use of antivirals.
sources:
- https://www.ameli.fr/assure/sante/themes/meningite-aigue/definition-causes-facteurs-favorisants
- https://www.associationpetitange.com/meningite-virale.html
- https://www.meningitis.ca/fr/ViralMeningitis