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Viral meningitis: Clinical features and diagnosis in children

Cecilia Di Pentima, MD
Section Editors
Morven S Edwards, MD
Douglas R Nordli, Jr, MD
Deputy Editor
Carrie Armsby, MD, MPH


The etiology, clinical manifestations, diagnosis, and differential diagnosis of viral meningitis in children will be reviewed here. The epidemiology, pathogenesis, management, prognosis, and prevention are discussed separately. (See "Viral meningitis: Epidemiology, pathogenesis, and etiology in children" and "Viral meningitis: Management, prognosis, and prevention in children".)


Meningitis – Meningitis is inflammation of the meninges, manifest by cerebrospinal fluid pleocytosis (ie, an increased number of white blood cells) [1].

Aseptic meningitis is the clinical syndrome of meningeal inflammation with negative cultures for routine bacterial pathogens in a patient who did not receive antibiotics before lumbar puncture [1-4]. Aseptic meningitis has a number of infectious and noninfectious causes (table 1). Viruses (usually enteroviruses) are the most common cause (table 2). Because viruses are the most common cause of aseptic meningitis, the terms aseptic meningitis and viral meningitis are sometimes used synonymously.

Encephalitis – Encephalitis is inflammation of the brain parenchyma that produces neurologic dysfunction (eg, altered mental status, behavior, or personality; motor or sensory deficits; speech or movement disorders; hemiparesis; and paresthesias) [5]. Encephalitis may occur during or after a viral infection. (See "Acute viral encephalitis in children: Clinical manifestations and diagnosis".)

Myelitis – Myelitis is inflammation of the spinal cord, manifest by weakness, bladder dysfunction, flaccid paralysis, and reduced or absent reflexes. (See "Disorders affecting the spinal cord", section on 'Acute viral myelitis'.)

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Literature review current through: Nov 2017. | This topic last updated: Sep 30, 2016.
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