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Viral Meningitis

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Key Resources English (5) French All (5)

CSF interpretation

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The Royal Children's Hospital Melbourne

Guideline to help with the interpretation of CSF results for the purpose of diagnosing or excluding meningitis.

Lumbar puncture

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The Royal Children's Hospital Melbourne

Guideline for performing lumbar puncture.

Meningitis - encephalitis

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The Royal Children's Hospital Melbourne

Guideline for the assessment and management of meningitis-encephalitis.

Aseptic Meningitis

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Melia M, Johns Hopkins ABX Guide

Guideline discussing aseptic meningitis pathogens, clinical presentation, diagnosis, treatment, and pathogen specific therapies.

Early Recognition of Meningitis and Septicaemia

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Royal College of Nursing, Meningitis Research Foundation

Guidance for front line nurses on the early recognition of meningitis and sepsis (what to look for).

CSF interpretation

Visit

The Royal Children's Hospital Melbourne

Guideline to help with the interpretation of CSF results for the purpose of diagnosing or excluding meningitis.

Lumbar puncture

Visit

The Royal Children's Hospital Melbourne

Guideline for performing lumbar puncture.

Meningitis - encephalitis

Visit

The Royal Children's Hospital Melbourne

Guideline for the assessment and management of meningitis-encephalitis.

Aseptic Meningitis

Visit

Melia M, Johns Hopkins ABX Guide

Guideline discussing aseptic meningitis pathogens, clinical presentation, diagnosis, treatment, and pathogen specific therapies.

Early Recognition of Meningitis and Septicaemia

Visit

Royal College of Nursing, Meningitis Research Foundation

Guidance for front line nurses on the early recognition of meningitis and sepsis (what to look for).

Systematic reviews English (6) French All (6)

Review: Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department

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Dorsett M, Liang SY

Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.

Systematic Review: Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis

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Sakushima K, Hayashino Y, Kawaguchi T, Jackson JL, Fukuhara S

Objective: Our study's purpose was to assess the utility of CSF lactate in differentiating bacterial meningitis from aseptic meningitis.

Systematic Review: Clinical features suggestive of meningitis in children: a systematic review of prospective data

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Curtis S, Stobart K, Vandermeer B, Simel DL, Klassen T

Objective: To seek evidence supporting accuracy of clinical features of pediatric bacterial meningitis.

Review: Treatment of herpes simplex virus infections in pediatric patients: current status and future needs

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James SH, Whitley RJ

Objective: To present an overview of the major clinical manifestations of HSV infections in the pediatric population.

Review: Emergency department management of meningitis and encephalitis

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Fitch MT, Abrahamian FM, Moran GJ, Talan DA

Objective: This article addresses considerations in clinical evaluation, need for CNS imaging before LP, interpretation of cerebrospinal fluid results, standards for and effects of timely antibiotic administration, and recommendations for specific antimicrobial therapy and corticosteroids.

Review: Viral meningitis

Visit

Logan SA, MacMahon E

Objective: In this review we outline the changing epidemiology, discuss key clinical topics, and illustrate how identification of the specific viral cause is beneficial. Neonatal meningitis may be a component of perinatal infection and is not covered here.

Review: Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department

Visit

Dorsett M, Liang SY

Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.

Systematic Review: Diagnostic accuracy of cerebrospinal fluid lactate for differentiating bacterial meningitis from aseptic meningitis: a meta-analysis

Visit

Sakushima K, Hayashino Y, Kawaguchi T, Jackson JL, Fukuhara S

Objective: Our study's purpose was to assess the utility of CSF lactate in differentiating bacterial meningitis from aseptic meningitis.

Systematic Review: Clinical features suggestive of meningitis in children: a systematic review of prospective data

Visit

Curtis S, Stobart K, Vandermeer B, Simel DL, Klassen T

Objective: To seek evidence supporting accuracy of clinical features of pediatric bacterial meningitis.

Review: Treatment of herpes simplex virus infections in pediatric patients: current status and future needs

Visit

James SH, Whitley RJ

Objective: To present an overview of the major clinical manifestations of HSV infections in the pediatric population.

Review: Emergency department management of meningitis and encephalitis

Visit

Fitch MT, Abrahamian FM, Moran GJ, Talan DA

Objective: This article addresses considerations in clinical evaluation, need for CNS imaging before LP, interpretation of cerebrospinal fluid results, standards for and effects of timely antibiotic administration, and recommendations for specific antimicrobial therapy and corticosteroids.

Review: Viral meningitis

Visit

Logan SA, MacMahon E

Objective: In this review we outline the changing epidemiology, discuss key clinical topics, and illustrate how identification of the specific viral cause is beneficial. Neonatal meningitis may be a component of perinatal infection and is not covered here.

Key studies English (5) French All (5)

Key study: Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines

Visit

Salazar L, Hasbun R

Objective: The main objectives of this study were to identify the adherence of clinicians to IDSA guidelines regarding cranial imaging in patients with CAM, to evaluate the clinical and prognostic differences between those patients with and without an indication for cranial imaging, and to assess the clinical impact in management in those with abnormal intracranial findings with or without altered mental status as their sole indication for imaging.

Key study: Improvement of the management of infants, children and adults with a molecular diagnosis of Enterovirus meningitis during two observational study periods

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Archimbaud C, Ouchchane L, Mirand A, Chambon M, Demeocq F, Labb A, Laurichess...

Objective: The aim of this study was to assess the impact of an EV positive diagnosis on the clinical management of patients admitted for meningitis over the course of two observational study periods (2005 and 2008-09) in the same clinical departments.

Key study: Impact of rapid enterovirus molecular diagnosis on the management of infants, children, and adults with aseptic meningitis

Visit

Archimbaud C, Chambon M, Bailly JL, Petit I, Henquell C, Mirand A, Aublet-Cuv...

Objective: Enteroviruses (EV) are the main etiological agents of aseptic meningitis. Diagnosis is made by detecting the genome using RTPCR. The aim of the study was to evaluate the impact of a positive diagnosis on the management of infants, children, and adults.

Key study: Interpretation of traumatic lumbar punctures: who can go home?

Visit

Mazor SS, McNulty JE, Roosevelt GE

Objective: To determine whether a ratio of observed to predicted (O:P) cerebrospinal fluid (CSF) white blood cells (WBCs) after a traumatic lumbar puncture (LP) can be used to predict which patients do not have meningitis and can safely be discharged from the hospital.

Key study: Cerebrospinal fluid findings in aseptic versus bacterial meningitis

Visit

Negrini B, Kelleher KJ, Wald ER

Objective: To assess 1) the characteristics of the CSF differential in aseptic versus bacterial meningitis, 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus bacterial meningitis.

Key study: Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines

Visit

Salazar L, Hasbun R

Objective: The main objectives of this study were to identify the adherence of clinicians to IDSA guidelines regarding cranial imaging in patients with CAM, to evaluate the clinical and prognostic differences between those patients with and without an indication for cranial imaging, and to assess the clinical impact in management in those with abnormal intracranial findings with or without altered mental status as their sole indication for imaging.

Key study: Improvement of the management of infants, children and adults with a molecular diagnosis of Enterovirus meningitis during two observational study periods

Visit

Archimbaud C, Ouchchane L, Mirand A, Chambon M, Demeocq F, Labb A, Laurichess...

Objective: The aim of this study was to assess the impact of an EV positive diagnosis on the clinical management of patients admitted for meningitis over the course of two observational study periods (2005 and 2008-09) in the same clinical departments.

Key study: Impact of rapid enterovirus molecular diagnosis on the management of infants, children, and adults with aseptic meningitis

Visit

Archimbaud C, Chambon M, Bailly JL, Petit I, Henquell C, Mirand A, Aublet-Cuv...

Objective: Enteroviruses (EV) are the main etiological agents of aseptic meningitis. Diagnosis is made by detecting the genome using RTPCR. The aim of the study was to evaluate the impact of a positive diagnosis on the management of infants, children, and adults.

Key study: Interpretation of traumatic lumbar punctures: who can go home?

Visit

Mazor SS, McNulty JE, Roosevelt GE

Objective: To determine whether a ratio of observed to predicted (O:P) cerebrospinal fluid (CSF) white blood cells (WBCs) after a traumatic lumbar puncture (LP) can be used to predict which patients do not have meningitis and can safely be discharged from the hospital.

Key study: Cerebrospinal fluid findings in aseptic versus bacterial meningitis

Visit

Negrini B, Kelleher KJ, Wald ER

Objective: To assess 1) the characteristics of the CSF differential in aseptic versus bacterial meningitis, 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus bacterial meningitis.