Journal
CURRENT OPINION IN INFECTIOUS DISEASES
Volume 30, Issue 2, Pages 248-256Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QCO.0000000000000355
Keywords
diagnostics; meningitis; therapeutics and sequelae; virus
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Funding
- European Union's Horizon 2020 research and innovation program [734584]
- National Institute for Health Research [NF-SI-0514-10177, 12/205/28, RP-PG-0108-10048, IS-HPU-1112-10117] Funding Source: researchfish
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Purpose of review The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome. Recent findings Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions. Despite improvements in diagnostics many laboratories do not use molecular methods and even when they are used many cases still remain without a proven viral aetiology identified. There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial. Summary Viruses are in increasingly important cause of meningitis in the era of declining bacterial disease. The exact viral aetiology varies according to age and country. Molecular diagnostics can not only improve the rate of pathogen detection but also reduce unnecessary antibiotics use and length of hospitalization. Further research is required into treatments for viral meningitis and the impact in terms of longer term sequelae.
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