The DOI matches its Crossref record; 116 of the 117 references it cites were found in a registry or an index; 72 of the 133 sources its claims cite were checked for support.
Viral meningitis: an overview
Open accessAbstract
Meningitis is a serious condition that affects the central nervous system. It is an inflammation of the meninges, which is the membrane that surrounds both the brain and the spinal cord. Meningitis can be caused by bacterial, viral, or fungal infections. Many viruses, such as enteroviruses, herpesviruses, and influenza viruses, can cause this neurological disorder. However, enteroviruses have been found to be the underlying cause of most viral meningitis cases worldwide. With few exceptions, the clinical manifestations and symptoms associated with viral meningitis are similar for the different causative agents, which makes it difficult to diagnose the disease at early stages. The pathogenesis of viral meningitis is not clearly defined, and more studies are needed to improve the health care of patients in terms of early diagnosis and management. This review article discusses the most common causative agents, epidemiology, clinical features, diagnosis, and pathogenesis of viral meningitis.
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Claims the paper makes
43 No full text of the sources · 37 Partly supported · 18 Supported · 9 Own interpretation · 5 Supported so far · 4 Not supported · 3 No basis given · 2 Couldn’t confirm · 2 Not checked yet · accuracy not yet measured
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Although these signs are widely used, studies have shown that the diagnostic accuracy of these physical assessments are not significantly different between meningitis cases and normal cases [26].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Disputedcites [26] Mehndiratta M et al (2012) Appraisal of Kernig’s and Brudzinski’s sign in meningitis. Ann Indian Acad Neurol 15(4):287 sourceExperimental — accuracy not yet measured
The Historical origin and clinical aspects section (p. 2) says Kernig’s and Brudzinski’s signs have low sensitivity but high specificity: when present, they suggest a high likelihood of meningitis. It does not report a statistical comparison with normal cases, and its conclusion runs contrary to the claim that these signs have no meaningful diagnostic difference between cases and non-cases. (LLM, conf=0.84)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Another study in the United Kingdom (UK) showed that the incidence of viral meningitis caused by EV and human parechovirus (HPeV) is double that of bacterial meningitis [9].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [9] Kadambari S et al (2019) Enterovirus and parechovirus meningitis in infants younger than 90 days old in the UK and Republic of Ireland: a British Paediatric Surveillance Unit study. Arch Dis Child 104(6):552–557 sourceExperimental — accuracy not yet measured
The Discussion reports that laboratory-confirmed EV/HPeV meningitis occurred at more than twice the estimated incidence of bacterial meningitis. The comparison is specifically for infants younger than 90 days in the UK and Republic of Ireland; the citing sentence omits that age restriction and presents the finding as applying to the UK generally. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The most recently detected viral agent causing meningitis was reported in a case study of a 24-year-old male from Japan who had aseptic meningitis caused by SARS-CoV-2, which was demonstrated by performing an RT-PCR test on a CSF sample from the patient.”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Supportedcites [14] Moriguchi T et al (2020) A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis 94:55–58 source
The Case section describes a 24-year-old man and reports that RT-PCR detected SARS-CoV-2 RNA in his CSF. The Introduction describes the diagnosis as aseptic encephalitis, while the Abstract and Discussion call it SARS-CoV-2-associated meningitis or meningitis/encephalitis; the Specimen collection section places testing at Yamanashi University Hospital in Japan. (LLM, conf=0.92)
boosteddirectSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“As the virus enters the body, it replicates mainly in the epithelium cells of the nasopharynx and the oropharyngeal and intestinal mucosa [56].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Partly supportedcites [56] Majer A, McGreevy A, Booth TF (2020) Molecular pathogenicity of enteroviruses causing neurological disease. Front Microbiol 11:540 sourceExperimental — accuracy not yet measured
The Routes of Enterovirus Neuroinvasion section (page unavailable) says that enteroviruses replicate in the gastrointestinal tract or, for EV-D68, the lungs during early disease, and that poliovirus primarily infects gastrointestinal epithelia. It does not identify the nasopharynx or oropharyngeal mucosa as main replication sites, so the cited paper supports only part of the claimed tissue distribution. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A proposed route of coxsackievirus entry to the CNS is through infected mononuclear cells (Mac-3) that can penetrate the BBB and invade the choroid plexus epithelium, allowing the spread of the virus into the CNS [64, 65].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Partly supportedcites [64] Tabor-Godwin JM et al (2010) A novel population of myeloid cells responding to coxsackievirus infection assists in the dissemination of virus within the neonatal CNS. J Neurosci 30(25):8676–8691 sourceExperimental — accuracy not yet measured
The Results section (‘Infected myeloid cells extravasate through the choroid plexus and into the ependymal cell layer’; page not provided) proposes that infected myeloid cells carry CVB3 through the choroid plexus into the neonatal CNS. It identifies this route as crossing the blood-CSF barrier, not the blood-brain barrier (BBB) named in the claim. The Discussion (page not provided) identifies the recruited cells as Mac3+ upon entry. (LLM, conf=0.88)
- Partly supportedcites [65] Huang H-I, Shih S-R (2015) Neurotropic enterovirus infections in the central nervous system. Viruses 7(11):6051–6066 sourceExperimental — accuracy not yet measured
Section 3 (page unavailable) says coxsackievirus infects Mac-3+ mononuclear cells that migrate toward the CNS and enter the brain through the choroid plexus epithelium. Section 7 (page unavailable) discusses nestin-positive myeloid cells crossing the blood-brain barrier, but does not identify them as the infected Mac-3+ cells. The specific claim that those cells penetrate the barrier is therefore not established by this copy. (LLM, conf=0.84)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“For example, EV-71 and coxsackievirus B have been detected in undifferentiated neural progenitor cells in mice after infection [58, 59].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [58] Huang H-I et al (2014) Enterovirus 71 infects brain-derived neural progenitor cells. Virology 468–470:592–600 source
- Supportedcites [59] Puccini JM et al (2014) Distinct neural stem cell tropism, early immune activation, and choroid plexus pathology following coxsackievirus infection in the neonatal central nervous system. Lab Invest 94(2):161–181 source
The Results describe infected nestin-positive progenitor cells in brain sections from neonatal mice infected with CVB3. The Discussion says coxsackievirus preferentially infected these cells in the subventricular zone. This supports the coxsackievirus B portion of the jointly cited sentence; the paper does not present an EV-71 infection finding. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“One study using a murine viral meningitis model in which mice were infected with lymphocytic choriomeningitis virus (LCMV) showed elevated levels of both IL-6 and INF-γ in CSF [50].”
§ Viral meningitis: an overview > Pathogenesis
What the sources say
- Supportedcites [50] Frei K et al (1988) Production of B cell stimulatory factor-2 and interferon gamma in the central nervous system during viral meningitis and encephalitis. Evaluation in a murine model infection and in patients. J Exp Med 168(1):449–453 source
The Introduction (p. 1) identifies BSF-2 as IL-6. The Results and Discussion (pp. 2–3) report increased CSF BSF-2 in LCMV-infected mice and a sharp rise in CSF IFN-γ after day 6. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“This dissemination of the virus leads to different complications, such as meningitis and encephalitis [62].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Supportedcites [62] de Crom SCM et al (2016) Enterovirus and parechovirus infection in children: a brief overview. Eur J Pediatr 175(8):1023–1029 source
The Pathogenesis section (page not provided) says that viremia can lead to secondary tissue infection and that secondary infection of the central nervous system results in meningitis or encephalitis. This supports the cited claim about complications following viral spread. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Once the viral agent enters the CNS, increased levels of chemoattractants, neutrophils, CD8 T cells, and monocytes are detected, indicating the induction of an immune response [46].”
§ Viral meningitis: an overview > Pathogenesis
What the sources say
- Supportedcites [46] Kim JV et al (2009) Myelomonocytic cell recruitment causes fatal CNS vascular injury during acute viral meningitis. Nature 457(7226):191–195 source
The paper’s main text reports increased CNS chemokine expression and recruitment of monocytes, neutrophils, and CD8+ cytotoxic T cells after LCMV infection in mice. These findings support the claimed immune response, although the reported cellular influx was most evident around day 6 rather than immediately upon infection. (LLM, conf=0.88)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Various studies have shown that EVs infect different neural cells, such as glia cells and astrocytes [56].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Supportedcites [56] Majer A, McGreevy A, Booth TF (2020) Molecular pathogenicity of enteroviruses causing neurological disease. Front Microbiol 11:540 source
The 'CNS Cell Types Susceptible to Enteroviruses' section explicitly reports that studies found enteroviruses infect neuronal progenitors, mature neurons, and glia cells such as astrocytes. The same section describes enterovirus infection of astrocytes in tissue cultures and detection of viral antigen in astrocytes from fatal cases. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
- It may state two separate claims as one. 69
- Probably not a substantial claim. 32
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“The gold standard tool for diagnosis of viral meningitis is the polymerase chain reaction (PCR), which detects and quantifies viral DNA or RNA in the patient’s CSF [41].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Disputedcites [41] Verstrepen WA et al (2001) Rapid detection of enterovirus RNA in cerebrospinal fluid specimens with a novel single-tube real-time reverse transcription-PCR assay. J Clin Microbiol 39(11):4093–4096 sourceExperimental — accuracy not yet measured
The paper’s introductory passage explicitly calls viral culture the “gold standard” for diagnosing enteroviral infections in CSF and describes RT-PCR as an alternative. Its assay detects and quantifies enterovirus RNA, but it does not establish PCR as the gold standard for viral meningitis generally. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“For instance, a high WBC count (≥ 500 cells/μl) with a large proportion of neutrophils (>80%) is usually observed in bacterial meningitis. Furthermore, in bacterial meningitis, the CSF glucose level typically does not exceed (300 mg/dL), but a decreased glucose CSF/blood ratio (< 0.4), and an elevated protein level (1 g/l) are indications of bacterial meningitis [2].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Disputedcites [2] Hoffman O, Weber JR (2009) Pathophysiology and treatment of bacterial meningitis. Ther Adv Neurol Disord 2(6):401–412 sourceExperimental — accuracy not yet measured
The Laboratory tests passage (Introduction; page not available) gives the opposite inequalities for three cited thresholds: WBC <500 cells/μl, protein <1 g/l, and CSF/blood glucose ratio >0.4. It supports predominant neutrophils but gives no >80% threshold or CSF glucose limit of 300 mg/dL. The verdict follows the inequalities as printed in our copy. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“As the virus enters the upper respiratory tract (URT), it binds to the N-acetylneuraminic acid α2,6-galactose receptor found on the surface of the epithelial cells. This receptor is predominant in the upper respiratory tract (URT) [73], which could explain the limited spread of the virus and its rare progression to neurological complications, such as meningitis.”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Disputedcites [73] Esposito S et al (2015) Enterovirus D68 infection. Viruses 7(11):6043–6050 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 0 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Checked by a reasoning model — may be wrong.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Additionally, a three-year study (2013-2015) in Egypt indicated that 573 out of 1337 meningitis cases (42.86%) were due to viral infections [18].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [18] Abdelkader MM et al (2017) Prevalence of MDR pathogens of bacterial meningitis in Egypt and new synergistic antibiotic combinations. PLoS ONE 12(2):e0171349–e0171349 sourceExperimental — accuracy not yet measured
The Results > Data analysis section reports 573 of 1,337 specimens (42.86%) as *possibly* viral meningitis. It describes a two-year study from September 2013 to September 2015, not a three-year study, and includes specimens classified as potentially misdiagnosed cases. The source therefore does not establish that 573 confirmed meningitis cases were due to viral infections. (LLM, conf=0.90)
hedgedn = 1,337- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In South Africa, children less than 10 years of age constituted 87.3% of those affected by an aseptic meningitis outbreak in which the responsible pathogen was coxsackievirus A9 [12].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [12] Smuts H et al (2018) Molecular characterization of an outbreak of enterovirus-associated meningitis in Mossel Bay, South Africa, December 2015-January 2016. BMC Infect Dis 18(1):709–709 sourceExperimental — accuracy not yet measured
The Abstract Results report that 55 of 63 patients (87.3%) were under 10, and the Conclusions identify coxsackievirus A9 as responsible for the South African outbreak. But the Results distinguish those 63 enterovirus-positive patients from the 43 cases classified as part of the outbreak. The paper does not establish that 87.3% of the outbreak cases were under 10. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Viral meningitis is the most common type of aseptic meningitis and usually affects young children [1].”
§ Viral meningitis: an overview > Introduction
What the sources say
- Partly supportedcites [1] Logan SA, MacMahon E (2008a) Viral meningitis. BMJ 336(7634):36–40 sourceExperimental — accuracy not yet measured
The ‘How common is viral meningitis?’ section says viral meningitis is most common in young children. The paper defines aseptic meningitis and discusses viral causes, but does not say that viral meningitis is the most common type of aseptic meningitis. Page numbers are unavailable in our copy. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Based on earlier studies in the Gulf region between 2000 and 2005, 37% of meningitis cases in the United Arab Emirates (UAE) were caused by viral infections, with a mortality rate of 3%. The same study also showed that children and young adults are the most affected age group [15].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [15] Dash N et al (2007) Epidemiology of meningitis in Al-Ain, United Arab Emirates, 2000–2005. Int J Infect Dis 11(4):309–312 sourceExperimental — accuracy not yet measured
The Abstract and Results report that 37% of 92 meningitis cases in Al-Ain Medical District were viral; the Results give a 3% case-fatality rate for viral meningitis. The claim extends this district-level finding to the UAE as a whole. The Results say viral cases occurred mainly among children and young adults, but the highest rate of meningitis overall was in children aged 0–5, not children and young adults collectively. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In another study from Kuwait, it was shown that 387 patients (mainly pediatric patients) had aseptic meningitis, with the most common viral agents being echovirus 9 (E-9), E-11 and E-30, accounting for 24% of the cases [16].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [16] Dalwai A, Ahmad S, Al-Nakib W (2010) Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait. Virol J 7(1):236 sourceExperimental — accuracy not yet measured
The Patient’s data section reports 387 children under 12 with aseptic meningitis, and Table 3 identifies E9, E11 and E30 as the most common detected enterovirus genotypes. But the Abstract’s Results assign 24% to all enterovirus-positive cases (92 of 387), not to those three echoviruses. Table 3 lists 60 cases with those genotypes, about 16% of the 387 cases. (LLM, conf=0.93)
plainn = 387- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A study conducted in England between 2011 and 2014 showed that the incidence of viral meningitis was 2.73 per 100,000, with the largest number of cases caused by non-polio enteroviruses [8].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [8] McGill F et al (2018) Incidence, aetiology, and sequelae of viral meningitis in UK adults: a multicentre prospective observational cohort study. Lancet Infect Dis 18(9):992–1003 sourceExperimental — accuracy not yet measured
The Results report enrollment across England from September 2011 to September 2014 and identify enteroviruses as the most frequent cause of confirmed viral meningitis (127 of 231 cases). The Discussion gives an estimated annual incidence of 2.73 per 100,000, but specifies UK adults with confirmed viral meningitis; it does not identify the enteroviruses as non-polio. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Furthermore, a study in Lebanon showed that 82.7% of study subjects were diagnosed with viral meningitis, while only 17.3% were diagnosed with bacterial meningitis [22].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Supportedcites [22] Haydar SM et al (2019) Adherence to international guidelines for the treatment of meningitis infections in Lebanon. Saudi Med J 40(3):260–265 source
The Abstract’s Results section explicitly reports 205 patients (82.7%) with viral meningitis and 47 (17.3%) with bacterial meningitis, matching the cited claim. The Discussion gives a different percentage breakdown, but the claim accurately reproduces the figures stated in the abstract. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Viral meningitis occurs throughout the year, but it is most commonly seen in summer and autumn [7].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [7] Logan SAE, MacMahon E (2008b) Viral meningitis. BMJ (Clinical research ed.) 336(7634):36–40 sourceExperimental — accuracy not yet measured
The “Who gets it?” section says enterovirus infection is highest in summer and autumn in temperate climates, but remains high year-round in tropical and subtropical climates. Enteroviruses are the most common cause of viral meningitis, yet the paper does not state that viral meningitis overall follows this year-round pattern or that its summer–autumn peak applies across climates. (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“This case report indicates the possible neuroinvasive potential of SARS-CoV-2 and its potential to cause CNS complications such as meningitis [14] (Tables 1 and 2).”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Supportedcites [14] Moriguchi T et al (2020) A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis 94:55–58 source
The Discussion describes the case as meningitis/encephalitis associated with SARS-CoV-2 and says it shows the virus’s neuroinvasive potential. The Case section also reports SARS-CoV-2 RNA detected in cerebrospinal fluid. The citing sentence’s qualified language accurately reflects the case report. (LLM, conf=0.94)
hedgedconditionalSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“According to the Palestinian Ministry of Health, the incidence of aseptic meningitis is 6.8 per 100,000 in the West Bank and 247 per 100,000 in the Gaza Strip [21].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Partly supportedcites [21] Dumaidi K, Al-Jawabreh A (2017) Molecular detection and genotyping of enteroviruses from CSF samples of patients with suspected sepsis-like illness and/or aseptic meningitis from 2012 to 2015 in West Bank, Palestine. PLoS ONE 12(2):e0172357–e0172357 sourceExperimental — accuracy not yet measured
The Introduction reports the same rates for the West Bank and Gaza Strip in 2014, and the Discussion figure caption identifies the incidence data as Ministry of Health-reported. But the source describes the rates as covering “sepsis-like illness and/or viral meningitis,” not aseptic meningitis alone. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Infection with EVs can lead to different clinical outcomes, such as respiratory illness, hepatitis, pancreatitis, myocarditis, and hand, foot, and mouth (HFM) disease [52, 53].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Supportedcites [52] Wells AI, Coyne CB (2019) Enteroviruses: a gut-wrenching game of entry, detection, and evasion. Viruses 11(5):460 source
The Introduction (§1.1) explicitly lists hand-foot-and-mouth disease and respiratory illness among minor clinical symptoms of enterovirus infection, and myocarditis, pancreatitis, and hepatitis among possible severe complications. This supports all the outcomes attributed to the source. (LLM, conf=0.95)
- Partly supportedcites [53] Akuzawa N et al (2014) Myocarditis, hepatitis, and pancreatitis in a patient with coxsackievirus A4 infection: a case report. Virol J 11:3–3 sourceExperimental — accuracy not yet measured
The Background and Discussion identify coxsackieviruses as enteroviruses associated with myocarditis and pancreatitis; the Case report describes liver dysfunction in a patient with coxsackievirus A4 infection. The Case report also mentions earlier cough and sore throat, but does not establish respiratory illness as an enterovirus outcome, and our copy does not address hand, foot, and mouth disease. No page numbers are available in our copy. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Other manifestations of the disease include short and fast breathing, loss of appetite, neck stiffness and pain, and sensitivity to bright light [28].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Partly supportedcites [28] Parikh V, Tucci V, Galwankar S (2012) Infections of the nervous system. Int J Crit Illn Inj Sci 2(2):82 sourceExperimental — accuracy not yet measured
The Meningitis > Neisseria meningitides section (page unavailable) lists a stiff neck and radicular pain; the Listeria section also reports poor feeding, but specifically in infants. The St. Louis encephalitis section lists photophobia with a viral meningitis presentation. Our copy does not identify short, fast breathing as a meningitis manifestation, and its support for loss of appetite is limited to infant poor feeding. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Children are usually less likely to present with meningeal complications and usually present with nonspecific illness, which makes meningitis more likely to be misdiagnosed in children [31].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Partly supportedcites [31] Shukla B et al (2017) Aseptic meningitis in adults and children: diagnostic and management challenges. J Clin Virol 94:110–114 sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says children in this aseptic-meningitis cohort were less likely than adults to present with meningeal complaints and notes that children often present with nonspecific febrile illness. Neither the Discussion nor the Results (page unavailable) establishes that meningitis is more likely to be misdiagnosed in children; the paper's diagnostic-challenge conclusion concerns unknown etiologies, not a higher pediatric misdiagnosis rate. (LLM, conf=0.87)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Moreover, it is made harder by the fact that most viral meningitis cases go undetected, and fatal cases manifest as severe encephalitic syndrome rather than meningitis [29].”
§ Viral meningitis: an overview > Pathogenesis
What the sources say
- Partly supportedcites [29] Irani DN (2008) Aseptic meningitis and viral myelitis. Neurol Clin 26(3):635 sourceExperimental — accuracy not yet measured
The Clinical Features section (page not supplied) reports that some viral infections with a more encephalitic presentation have adverse outcomes, while aseptic meningitis is typically self-limited. It does not establish that fatal cases generally present as severe encephalitis, or that most viral meningitis cases go undetected. (LLM, conf=0.83)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Next-generation sequencing (NGS) was recently used in a number of studies to detect a wide variety of pathogens, including viruses, the possible application of this technique as a diagnostic tool in meningitis cases is not yet clear, and more studies are required [45].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Supportedcites [45] Poplin V, Boulware DR, Bahr NC (2020) Methods for rapid diagnosis of meningitis etiology in adults. Biomark Med 14(6):459–479. https://doi.org/10.2217/bmm-2019-0333 source
The Nucleic acid amplification tests section says NGS can detect a wide variety of pathogens and describes recent studies detecting bacterial and viral pathogens in CSF. It also says the field is young and NGS’s role in meningitis is unclear. The Next-generation sequencing section adds that further study is required. (LLM, conf=0.94)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In addition, EV-D68 strains were able to infect and replicate in a human neuroblastoma cell line and a postnatal cortical neuron culture, but non-neurotropic strains were not [60].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Partly supportedcites [60] Brown DM et al (2018) Contemporary circulating enterovirus D68 strains have acquired the capacity for viral entry and replication in human neuronal cells. mBio 9(5):e01954-e2018 sourceExperimental — accuracy not yet measured
The Results report that US/MO/47 replicated in the SH-SY5Y neuroblastoma cell line and primary human neurons, whereas US/TN and VR1197 did not. Materials and Methods identifies the latter culture as human postnatal brain neurons, but our copy does not identify them as cortical neurons. (LLM, conf=0.82)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Echoviruses, such as E-6, E-9, E-11, E-13, E-19, and E-30 also belong to the species Enterovirus B and are commonly known to be associated with viral meningitis in children [69].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Supportedcites [69] Kim H-J et al (2012) Epidemics of viral meningitis caused by echovirus 6 and 30 in Korea in 2008. Virol J 9:38–38. https://doi.org/10.1186/1743-422X-9-38 source
The Background classifies E6, E9, E11, E13, E19, and E30 as Human enterovirus B and identifies these same genotypes as commonly detected in patients with aseptic meningitis. It also describes aseptic meningitis in children as a common serious illness associated with enteroviral infection. (LLM, conf=0.94)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The presence of neutrophilic pleocytosis is usually indicative of bacterial meningitis rather than viral meningitis. However, it has been found that 25% of patients with CNS abnormalities caused by viral agents have neutrophilic pleocytosis [39].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Supportedcites [39] Jaijakul S et al (2017) The clinical significance of neutrophilic pleocytosis in cerebrospinal fluid in patients with viral central nervous system infections. Int J Infect Dis 59:77–81 source
The Discussion says neutrophilic pleocytosis in patients presenting with meningitis is usually interpreted as indicative of bacterial meningitis, but that 25% of patients with confirmed viral causes have it. The Results specify that 45 of 182 patients with documented viral CNS infections (25%) had CSF neutrophilic predominance. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In viral meningitis, the WBC count typically ranges between 80 and 100 cells/μl (pleocytosis), with a large proportion of lymphocytes (>80%) [21]. Also, glucose and protein levels usually remain normal [35].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Partly supportedcites [21] Dumaidi K, Al-Jawabreh A (2017) Molecular detection and genotyping of enteroviruses from CSF samples of patients with suspected sepsis-like illness and/or aseptic meningitis from 2012 to 2015 in West Bank, Palestine. PLoS ONE 12(2):e0172357–e0172357 sourceExperimental — accuracy not yet measured
The Introduction (page not provided) describes CSF pleocytosis as a feature of aseptic meningitis, supporting that limited part of the cited clause. It gives age-dependent WBC thresholds, not a typical count of 80–100 cells/μl, and does not report lymphocytes exceeding 80%. The Results (page not provided) also report that many enterovirus-positive patients lacked pleocytosis. The separate statement about glucose and protein cites [35], not this source. (LLM, conf=0.82)
- Not matchedcites [35] Seehusen DA, Reeves M, Fomin D (2003) Cerebrospinal fluid analysis. Am Fam Physician 68(6):1103–1108
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Gram staining and bacterial culture are the key diagnostic tools for identifying bacterial infections [2], and viral meningitis is suspected when Gram staining and culture of CSF are negative.”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Supportedcites [2] Hoffman O, Weber JR (2009) Pathophysiology and treatment of bacterial meningitis. Ther Adv Neurol Disord 2(6):401–412 source
The Laboratory tests passage (Introduction) says that the key to diagnosing bacterial meningitis is detecting bacteria in CSF by Gram staining or a positive bacterial culture. Citation [2] is attached to that diagnostic-tools clause; the separate statement about suspecting viral meningitis is not attributed to this source. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The pathogenesis of viral meningitis begins when the causative agent enters the host through respiratory secretions or by the fecal-oral route to cause primary infection in the respiratory or gastrointestinal (GI) tract. This is followed by secondary infection of the CNS, causing meningitis or other neurological problems.”
§ Viral meningitis: an overview > Pathogenesis
What the sources say
- Partly supportedcites [46] Kim JV et al (2009) Myelomonocytic cell recruitment causes fatal CNS vascular injury during acute viral meningitis. Nature 457(7226):191–195 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [47] Wolinsky JS, Klassen T, Baringer JR (1976) Persistence of neuroadapted mumps virus in brains of newborn hamsters after intraperitoneal inoculation. J Infect Dis 133(3):260–267 source
- Not checked — no full text of the sourcecites [48] Wong KT et al (2008) The distribution of inflammation and virus in human enterovirus 71 encephalomyelitis suggests possible viral spread by neural pathways. J Neuropathol Exp Neurol 67(2):162–169 source
- Partly supportedcites [49] Munster VJ et al (2012) Rapid Nipah virus entry into the central nervous system of hamsters via the olfactory route. Sci Rep 2(1):736 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“In addition, difficulty in focusing or concentrating as well as double vision can also be associated with meningitis and may continue after recovery [29].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Could not verifycites [29] Irani DN (2008) Aseptic meningitis and viral myelitis. Neurol Clin 26(3):635 sourceExperimental — accuracy not yet measured
The Aseptic Meningitis Clinical Features section says that symptoms in adults with enteroviral meningitis may persist for several weeks. It does not identify difficulty concentrating or double vision, or say that either continues after recovery. Searches for focusing, concentration, double vision, and diplopia found no passage addressing those symptoms. (LLM, conf=0.73)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“There are a number of risk factors that are known to increase one's susceptibility to contracting viral meningitis, including compromised immunity, age, travel history, and HIV infection [7].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Partly supportedcites [7] Logan SAE, MacMahon E (2008b) Viral meningitis. BMJ (Clinical research ed.) 336(7634):36–40 sourceExperimental — accuracy not yet measured
“How common is viral meningitis?” reports that incidence is highest in young children, and “What causes it?” (box 1) links immunocompromised hosts and travel history to particular viral causes. The “Human immunodeficiency virus” section identifies primary HIV infection as a cause of aseptic meningitis. The paper does not establish that all four factors generally increase susceptibility to contracting viral meningitis; travel history, in particular, is presented as a clue to the possible cause of an existing case. (LLM, conf=0.85)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Viral infection of the CNS can occur through different mechanisms, such as infection of the choroid plexus epithelium, infection of the lymphoid tissue, induction of inflammation and blood-brain barrier (BBB) breakdown, and infection of peripheral sensory neural pathways [46–49] (Fig. 1).”
§ Viral meningitis: an overview > Pathogenesis
What the sources say
- Partly supportedcites [46] Kim JV et al (2009) Myelomonocytic cell recruitment causes fatal CNS vascular injury during acute viral meningitis. Nature 457(7226):191–195 sourceExperimental — accuracy not yet measured
The main text reports blood–brain barrier breakdown and inflammatory cell recruitment during LCMV infection of the murine CNS. But the Methods (Virus; page unavailable) say the mice were infected intracerebrally, and the paper treats barrier breakdown as injury following infection—not as a route by which virus enters the CNS. Our copy does not support the listed choroid plexus, lymphoid-tissue, or sensory-neural pathways. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [47] Wolinsky JS, Klassen T, Baringer JR (1976) Persistence of neuroadapted mumps virus in brains of newborn hamsters after intraperitoneal inoculation. J Infect Dis 133(3):260–267 source
- Not checked — no full text of the sourcecites [48] Wong KT et al (2008) The distribution of inflammation and virus in human enterovirus 71 encephalomyelitis suggests possible viral spread by neural pathways. J Neuropathol Exp Neurol 67(2):162–169 source
- Partly supportedcites [49] Munster VJ et al (2012) Rapid Nipah virus entry into the central nervous system of hamsters via the olfactory route. Sci Rep 2(1):736 sourceExperimental — accuracy not yet measured
The Results (Entry of Nipah virus into the CNS) directly document entry along olfactory neurons, supporting the peripheral sensory neural pathway. The Discussion describes blood–brain barrier disruption as a proposed route but says it was unlikely to be the initial route in these hamsters; it also discusses inflammation as a possible cause of barrier breakdown, not as a demonstrated entry mechanism. Our copy does not describe CNS entry through infection of the choroid plexus epithelium or lymphoid tissue. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Four glycoproteins in HSV-1 and HSV-2 are important for viral entry (gB, gD, gH, and gL); however, cell binding is mediated by only two glycoproteins, gB and/or gC, that bind to cell-surface heparan sulfate [82].”
§ Viral meningitis: an overview > Pathogenesis > Family Herpesviridae
What the sources say
- Supportedcites [82] Spear PG, Longnecker R (2003) Herpesvirus entry: an update. J Virol 77(19):10179–10185 source
The ALPHAHERPESVIRUS (HSV) ENTRY section identifies gB, gD, gH, and gL as required for HSV-1 entry and says gB and/or gC mediate binding to cell-surface heparan sulfate. It presents this as its summary of HSV-1 and HSV-2 entry. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The virus can also infect the endothelial cells of blood vessels in the brain, causing latent infection. When the brain undergoes stress, the virus can be activated and the expression of different cytokines and chemokines, such as IL-1, TNF-α, IL-12 and IL18 increases, resulting in an inflammatory response [86].”
§ Viral meningitis: an overview > Pathogenesis > Family Herpesviridae
What the sources say
- Partly supportedcites [86] Koyuncu OO, Hogue IB, Enquist LW (2013) Virus infections in the nervous system. Cell Host Microbe 13(4):379–393. https://doi.org/10.1016/j.chom.2013.03.010 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Enterovirus D68 (EV-D68) is the most common member of the species Enterovirus D found to be associated with the development of aseptic meningitis. EV-D68 can cause CNS complications in children, commonly meningitis and flaccid paralysis [72].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Partly supportedcites [72] González-Sanz R et al (2019) Enterovirus D68-associated respiratory and neurological illness in Spain, 2014–2018. Emerg Microbes Infect 8(1):1438–1444 sourceExperimental — accuracy not yet measured
The non-respiratory-disease results (p. 4) report EV-D68 in children with meningitis or meningoencephalitis and acute flaccid paralysis. But the paper calls EV-D68 the most frequently detected enterovirus in its respiratory samples (Abstract, p. 2), not the most common member of species Enterovirus D associated with aseptic meningitis. The Discussion (p. 7) also says the association with paralysis is accepted but causality has not been proven, so “can cause” is stronger than its conclusion. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Valacyclovir was also tested in clinical trials for its antiviral suppression ability on recurrence of meningitis. However, treatment with valacyclovir (twice daily) did not prevent recurrent meningitis and was not recommended for this purpose [105, 106].”
§ Viral meningitis: an overview > Management
What the sources say
- Supportedcites [105] Aurelius E et al (2012) Long-term valacyclovir suppressive treatment after herpes simplex virus type 2 meningitis: a double-blind, randomized controlled trial. Clin Infect Dis 54(9):1304–1313 source
The Discussion reports that this randomized trial found no effect of 0.5 g valacyclovir twice daily on meningitis recurrence. It also says the data do not support suppression at the tested dosage following HSV-2 meningitis, matching the claim that this regimen was not recommended for that purpose. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [106] Kato K et al (2015) Recurrent neonatal herpes simplex virus infection with central nervous system disease after completion of a 6-month course of suppressive therapy: case report. J Infect Chemother 21(12):879–881 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Recently, a promising drug called psoromic acid (a bioactive lichen-derived compound) has been found to inhibit the replication of both HSV-1 and HSV-2 by inhibiting proteases and DNA polymerases, which makes it a possible drug for treating meningitis caused by HSV [104].”
§ Viral meningitis: an overview > Management
What the sources say
- Partly supportedcites [104] Hassan STS et al (2019) Psoromic acid, a lichen-derived molecule, inhibits the replication of HSV-1 and HSV-2, and inactivates HSV-1 DNA polymerase: shedding light on antiherpetic properties. Molecules (Basel, Switzerland) 24(16):2912 sourceExperimental — accuracy not yet measured
Results and Discussion §2.1 reports that psoromic acid inhibits HSV-1 and HSV-2 replication, and §2.2 links its anti-HSV-1 activity to inhibition of HSV-1 DNA polymerase. Section 2.4 suggests HSV-2 protease inhibition from molecular docking, rather than demonstrating that protease inhibition causes reduced replication. The paper does not assess psoromic acid as a treatment for HSV meningitis. (LLM, conf=0.88)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Infection of the CNS by WNV activates Toll-like receptor 3, increases the concentration of TNF-α and other pro-inflammatory factors, which in turn increases the permeability of the BBB and leads to neural death [96].”
§ Viral meningitis: an overview > Pathogenesis > Arboviruses
What the sources say
- Partly supportedcites [96] Lim SM et al (2011b) West Nile virus: immunity and pathogenesis. Viruses 3(6):811–828 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A recent systematic analysis showed that most viral meningitis cases have a good long-term clinical outcome and that patients with viral meningitis have a better outcome after hospital discharge than patients with viral encephalitis [109].”
§ Viral meningitis: an overview > Management
What the sources say
- Partly supportedcites [109] Hudson JA et al (2020) Outcomes beyond hospital discharge in infants and children with viral meningitis: a systematic review. Rev Med Virol 30(2):e2083 sourceExperimental — accuracy not yet measured
The Discussion reports good clinical outcomes in the majority of cases, but the review covers infants and children, not patients of all ages. It also says its results “suggest” children with viral meningitis “may have better outcomes” than children with viral encephalitis; the citing sentence presents that comparison as established. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“EBV pathogenesis starts when the virus infects oropharyngeal epithelium cells. It then spreads to the lymphoid tissue and infects lymphoid cells, mainly B cells. In the infected B cell population, the virus can be latent or, less frequently, lytic. In the latent stage, the virus mainly expresses EBNAs (Epstein-Barr nuclear antigens) and LMPs (latent membrane proteins) [85].”
§ Viral meningitis: an overview > Pathogenesis > Family Herpesviridae
What the sources say
- Could not verifycites [85] Akkoc G et al (2016) Epstein-Barr virus encephalitis in an immunocompetent child: a case report and management of Epstein-Barr virus encephalitis. Case Rep Infect Dis 2016 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“All of these viruses are known to cause meningitis and can establish a latent infection in neurons, which can be reactivated [82].”
§ Viral meningitis: an overview > Pathogenesis > Family Herpesviridae
What the sources say
- Partly supportedcites [82] Spear PG, Longnecker R (2003) Herpesvirus entry: an update. J Virol 77(19):10179–10185 sourceExperimental — accuracy not yet measured
The opening section says HSV-1 and HSV-2 can cause meningitis and that they, along with VZV, establish latent infections in neurons and can reactivate from neurons. It does not say VZV causes meningitis, so the claim's 'all of these viruses' wording is not fully supported. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Human influenza viruses often cause pneumonia and acute respiratory distress syndrome (ARDS) [87], but on rare occasions, they can cause extra-respiratory illnesses, including meningitis [87], encephalitis [88], meningoencephalitis, and myelitis [89].”
§ Viral meningitis: an overview > Pathogenesis > Family Orthomyxoviridae
What the sources say
- Partly supportedcites [87] Liang C-Y, Yang C-H, Lin J-N (2018) Focal encephalitis, meningitis, and acute respiratory distress syndrome associated with influenza A infection. Med Princ Pract 27(2):193–196 sourceExperimental — accuracy not yet measured
The Introduction lists pneumonia and meningitis among influenza complications, and the Conclusion says neurologic complications are infrequent compared with respiratory symptoms. The Conclusion also reports one patient with acute respiratory distress syndrome (ARDS), but the paper does not establish that influenza often causes ARDS; a single case cannot support that frequency claim. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [88] Sejvar JJ, Uyeki TM (2010) Neurologic complications of 2009 influenza A (H1N1). Neurology 74(13):1020 source
- Partly supportedcites [89] Xia J-B et al (2014) H7N9 influenza A-induced pneumonia associated with acute myelitis in an adult. Intern Med 53(10):1093–1095 sourceExperimental — accuracy not yet measured
Citation [89] follows “meningoencephalitis, and myelitis.” The Introduction says influenza-associated nervous-system symptoms are uncommon and lists myelitis among reported complications; the Abstract describes a patient with H7N9-associated acute myelitis. Our copy does not mention meningoencephalitis, so that part of the attributed claim is unsupported. (LLM, conf=0.87)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Partly supported
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In the paper
“HVEM is present on the surface of various cell types, including epithelial cells and neurons. Accordingly, viral entry through this receptor is suggested in meningitis.”
§ Viral meningitis: an overview > Pathogenesis > Family Herpesviridae
What the sources say
- Partly supportedcites [82] Spear PG, Longnecker R (2003) Herpesvirus entry: an update. J Virol 77(19):10179–10185 sourceExperimental — accuracy not yet measured
The HSV entry section (page not specified) identifies HVEM as an entry receptor and says it is expressed in various cell types, including epithelial cells. It attributes neuronal expression and potential entry into neurons to nectins, not HVEM, and does not suggest HVEM-mediated entry in meningitis. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Three known cellular receptors have been identified for HSV: 1) herpesvirus entry mediator (HVEM), 2) members of the immunoglobulin superfamily, and 3) heparan sulfate generated by certain isoforms of 3-O-sulfotransferases [82].”
§ Viral meningitis: an overview > Pathogenesis > Family Herpesviridae
What the sources say
- Supportedcites [82] Spear PG, Longnecker R (2003) Herpesvirus entry: an update. J Virol 77(19):10179–10185 source
The ALPHAHERPESVIRUS (HSV) ENTRY section explicitly identifies three classes of HSV entry receptors: HVEM, the immunoglobulin-superfamily members nectin-1 and nectin-2, and specific sites in heparan sulfate generated by certain 3-O-sulfotransferases. This matches the three classes attributed to the source. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The pathogenesis of the virus depends mainly on the replication of virus in the host's lymph nodes and skin keratinocytes [95], resulting in primary viremia. The virus can then spread to secondary locations such as CNS after penetrating the BBB [96].”
§ Viral meningitis: an overview > Pathogenesis > Arboviruses
What the sources say
- Not checked — no full text of the sourcecites [95] Lim P-Y et al (2011a) Keratinocytes are cell targets of West Nile virus in vivo. J Virol 85(10):5197–5201 source
- Partly supportedcites [96] Lim SM et al (2011b) West Nile virus: immunity and pathogenesis. Viruses 3(6):811–828 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Some vaccines have been developed for some viruses such as EV-71 [107], considering its clinical significance, and the different types of EV-71 vaccines are summarized in Table 4.”
§ Viral meningitis: an overview > Management
What the sources say
- Supportedcites [107] Yi E-J et al (2017) Enterovirus 71 infection and vaccines. Clin Exp Vaccine Res 6(1):4–14 source
The 'Development of EV71 Vaccine Candidates' section lists several types of EV71 vaccines. The 'Approved EV71 Vaccines' section also reports that two EV71 vaccines had been approved and were in commercial production, directly supporting the claim that vaccines have been developed for EV71. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“E-30 can cause neural damage by modulating the function of the TRIO protein. In the first pathway, the virus affects the function of guanine exchange factor domain 2 (GEFD2), which results in the activation of Ras homology family member A (RhoA), a GTPase signaling protein. This activates both the ROCK and MLC signaling pathways. This cascade of events leads to actin formation and elevation of the”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Partly supportedcites [71] Lee J-W et al (2012) Echovirus 30 induced neuronal cell death through TRIO-RhoA signaling activation. PLoS ONE 7(5):e36656–e36656 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Moreover, V-7404 (viral polymerase inhibitor) and DAS181 (sialidase) are newly developed drugs against EV-D68 [73, 76].”
§ Viral meningitis: an overview > Management
What the sources say
- Partly supportedcites [73] Esposito S et al (2015) Enterovirus D68 infection. Viruses 7(11):6043–6050 sourceExperimental — accuracy not yet measured
Section 5 (Diagnosis, Treatment and Prevention; page not provided) reports strong inhibitory activity against EV-D68 for both compounds and identifies DAS181 as a sialidase fusion protein. But it calls V-7404 a protease inhibitor, not a polymerase inhibitor, and says the drugs are being developed for other infections while remaining possible candidates for EV-D68 outbreaks. (LLM, conf=0.90)
- Could not verifycites [76] Messacar K et al (2018) Enterovirus D68 and acute flaccid myelitis-evaluating the evidence for causality. Lancet Infect Dis 18(8):e239–e247 sourceExperimental — accuracy not yet measured
The Introduction (page unavailable) calls for further research to inform treatment, but does not identify V-7404 or DAS181 as drugs against EV-D68. Searches for both drug names and their proposed roles found no passage addressing the claim. (LLM, conf=0.75)
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
In the paper
“Moreover, higher percentages of viral meningitis were reported in Jordan, reaching 83% of all meningitis cases between 2001 and 2004, and 81% in 2014 [19].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked yetcites [19] Alzein K (2016) Revision of meningitis surveillance system in Jordan during 2001 and 2014 years. Epidemiol (sunnyvale) 6:220. https://doi.org/10.4172/2161-1165.100022 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The pathogenesis of viral meningitis is not clearly defined, and more studies are needed to improve the health care of patients in terms of early diagnosis and management.”
§ Viral meningitis: an overview > Abstract
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“In a two-year study in Gaza (2013–2014), 72% of meningitis cases were classified as viral meningitis, caused mainly by an EV infection (35%) [20].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [20] Ghuneim N, Dheir M, AbuAli K (2016) Epidemiology of different types of meningitis cases in gaza governorates, occupied Palestinian Territory, December 2013–January 2014. J Antivir Antiretrovir 8(1):26–34 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In addition, a study done in Denmark showed similar findings, with non-polio enteroviruses being the most common causative agent. They also showed that the incidence of aseptic meningitis decreases with increasing age (58.7 per 100,000 after birth, 38.7 per 100,000 in 6-month-old infants, and 15.6 per 100,000 in 5-year-old children) [10] (Table 1).”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [10] Hviid A, Melbye M (2007) The epidemiology of viral meningitis hospitalization in childhood. Epidemiology 18(6):695–701 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In Austria (2001-2004), 56% of the patients included in a study had viral meningitis, where E-30 (36.4%), coxsackievirus-B (19.6%), and EV-71 (13.1%) were the viruses that were most frequently found [13].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [13] Ortner B et al (2009) Epidemiology of enterovirus types causing neurological disease in Austria 1999–2007: detection of clusters of echovirus 30 and enterovirus 71 and analysis of prevalent genotypes. J Med Virol 81(2):317–324 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Also, a study conducted in China found that viral meningitis caused by EV-71 accounted for approximately 55.2% of neurological disorders [11].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [11] Hu Y, Jiang L, Peng H-L (2015) Clinical analysis of 134 children with nervous system damage caused by enterovirus 71 infection. Pediatr Infect Dis J 34(7):718–723 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In Egypt, out of 250 confirmed cases of meningitis, 17 were caused by viral agents, and the most commonly encountered viruses were EV, herpes simplex virus (HSV), and varicella zoster virus (VZV) [23].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked yetcites [23] Selim HS et al (2007) Microbial study of meningitis and encephalitis cases. J Egypt Public Health Assoc 82(1–2):1–19
plainn = 250- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In Qatar, it has been estimated that the incidence of viral meningitis from 2011 to 2015 was 6.4 per 100,000, with most cases being children infected with EV [17].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [17] Abid FB et al (2018) Epidemiology and clinical outcomes of viral central nervous system infections. Int J Infect Dis 73:85–90 source
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With few exceptions, the clinical manifestations and symptoms associated with viral meningitis are similar for the different causative agents, which makes it difficult to diagnose the disease at early stages.”
§ Viral meningitis: an overview > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Another study demonstrated that this virus replicates in monocytes, T cells, and B cells during the viremia phase and that the level of susceptibility of immune cells to infection determines the severity of secondary organ damage [67], such as causing severe meningitis after reaching the CNS.”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [67] Hwang JY et al (2012) Characterization of infections of human leukocytes by non-polio enteroviruses. Intervirology 55(5):333–341 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Patients with meningitis usually suffer from fever, chills, abdominal pain, nausea, and headache [5].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [5] Kumar R (2005) Aseptic meningitis: diagnosis and management. Indian J Pediatr 72(1):57–63 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Moreover, analysis of brain tissues obtained from mice born to mothers inoculated with coxsackievirus B4 showed signs of meningitis and accumulation of immune cells (mainly T cells) and increased secretion of inflammatory cytokines and chemokines (IL6, TNF-α, IFNα and MCP-1) [68].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [68] Jmii H et al (2020) Immunopathology in the brain of mice following vertical transmission of Coxsackievirus B4. Microb Pathog 103965 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“A systematic review done by Iguchi and colleagues showed that jolt accentuation can be used in emergency settings to exclude meningitis. However, the pooled sensitivity and specificity of this test (65.3%, 70.4% respectively) are considered low, and more research is needed to assess its usefulness [32].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [32] Iguchi M et al (2020) Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD012824 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“They can also undergo vertical transmission from an infected mother to her infant by crossing the placenta or through breastfeeding [55].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [55] Mereaux J et al (2017) Enterovirus infection during pregnancy: Underestimated cause of fetal and neonatal complications? Gynecologie, obstetrique, fertilite & senologie 45(4):231–237 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, the pathogenesis of aseptic meningitis is not well understood, and it is difficult to study due to limited data.”
§ Viral meningitis: an overview > Pathogenesis
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“On the other hand, diagnosis of mumps virus, herpesvirus, arboviruses, and human immunodeficiency virus (HIV) infections can be achieved using serological assays, although the results might be negative at early stages of the disease. Hence, a second sample should be obtained after two weeks and tested again for the presence of viral agents [5].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [5] Kumar R (2005) Aseptic meningitis: diagnosis and management. Indian J Pediatr 72(1):57–63 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Enteroviruses can be transmitted through respiratory secretions or by the fecal-oral route [54].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [54] Burrell CJ, Howard CR, Murphy FA (2017) Chapter 32—picornaviruses. In: Burrell CJ, Howard CR, Murphy FA (eds) Fenner and White’s Medical virology (Fifth Edition). Academic, London, pp 447–463 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Skin rash is also observed with certain types of meningitis and is considered a late sign of bacterial meningitis, where the pathogen in the blood targets the capillary cells, leading to their damage [30].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [30] Tsai J, Nagel MA, Gilden D (2013) Skin rash in meningitis and meningoencephalitis. Neurology 80(19):1808–1811 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“However, since obtaining CSF is difficult, alternative specimens, such as blood, throat or nasal swabs, or stool samples might be used instead, particularly in cases of suspected EV infections [44].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [44] Kupila L et al (2005) Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clin Infect Dis 40(7):982–987 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A recent case report described a 9-day-old newborn admitted to the emergency department with nonspecific symptoms of fever and irritability. Molecular analysis (RT-PCR and sequencing) showed that the patient was positive for EV (specifically, E-25) and viral meningitis was diagnosed [43].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [43] Alhazmi A et al (2020) Repeated viral meningitis in a newborn. J NeuroVirol 1–3 source
plainSingle case- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Also, the virus could reach the bloodstream by infecting immune cells and cause secondary infections at other sites, such as the heart and CNS [61].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [61] Palacios G, Oberste M (2005) Enteroviruses as agents of emerging infectious diseases. J Neurovirol 11(5):424–433 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In most cases, the virus enters the body through the oral-fecal route until it reaches the lower gastrointestinal (GI) tract, where it binds to a specific receptor on the surface of enterocytes and crosses the lining of the intestine, reaching the Peyer’s patches, where it continues its replication [57].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [57] Rotbart HA (2000) Viral meningitis. In: Seminars in neurology. Copyright© 2000 by Thieme Medical Publishers, Inc source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Another study in Egypt done on pediatric patients with aseptic meningitis found that 56% of cases were due to EV [24].”
§ Viral meningitis: an overview > Epidemiology
What the sources say
- Not checked — no full text of the sourcecites [24] Shaker OG, Abdelhamid N (2015) Detection of enteroviruses in pediatric patients with aseptic meningitis. Clin Neurol Neurosurg 129:67–71 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Similarly, in a study of HPeV-positive meningitis cases, 100% sensitivity was achieved with RT-PCR, while viral culture failed to detect the virus [42].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [42] De Crom S et al (2013) Prospective comparison of the detection rates of human enterovirus and parechovirus RT-qPCR and viral culture in different pediatric specimens. J Clin Virol 58(2):449–454 source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In fact, signs and symptoms of meningitis can be similar to those of other diseases such as encephalitis or brain abscesses, and hence, viral meningitis can be misdiagnosed [25].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [25] Visintin C et al (2010) Management of bacterial meningitis and meningococcal septicaemia in children and young people: summary of NICE guidance. BMJ 340:c3209 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Pleocytosis generally is considered an important criterion for diagnosis of viral meningitis. However, a number of studies have shown that pleocytosis is often not observed in EV meningitis cases involving infants (38%) or children (39%), or when a lumbar puncture is performed at an early stage of disease [36, 37].”
§ Viral meningitis: an overview > Clinical manifestations and diagnosis
What the sources say
- Not checked — no full text of the sourcecites [36] de Crom SC et al (2012) Characteristics of pediatric patients with enterovirus meningitis and no cerebral fluid pleocytosis. Eur J Pediatr 171(5):795–800 source
- Not checked — no full text of the sourcecites [37] Alhazmi A et al (2019) Paediatric enterovirus meningitis without cerebrospinal fluid pleocytosis. J Infect 79(6):612–625 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, a strong inflammatory immune response is induced during aseptic meningitis and plays an important role in the pathogenesis of the disease.”
§ Viral meningitis: an overview > Pathogenesis
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although patients with viral meningitis usually do not need to be hospitalized, treatment should be provided, such as antipyretics, antiemetics, and analgesics, which can be taken at home. However, some patients, such as those who suffer from seizures, need to be under medical supervision [5].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [5] Kumar R (2005) Aseptic meningitis: diagnosis and management. Indian J Pediatr 72(1):57–63 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Recently, an EV-D68 virus-like particle vaccine (VLP) has been developed [108]. The VLP is composed of a recombinant baculovirus expressing 3CD protease and P1 precursor. Clinical trials showed a high efficacy of the vaccine [108].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [108] Dai W et al (2018) A virus-like particle vaccine confers protection against enterovirus D68 lethal challenge in mice. Vaccine 36(5):653–659 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Regarding to HSV treatment, one study showed that antiviral therapy in immunocompromised patients with HSV-induced meningitis should be started immediately and that any delay in the administration of treatment can result in the development of adverse complications [102].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [102] Momméja-Marin H et al (2003) Herpes simplex virus type 2 as a cause of severe meningitis in immunocompromised adults. Clin Infect Dis 37(11):1527–1533 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In fact, the lack of a receptor in the respiratory tract might explain why HPeV-3 commonly causes meningitis and neonatal sepsis, while HPeV-1 causes respiratory and gastrointestinal illness.”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Several arboviruses of different families have been associated with CNS infection and development of meningitis. These include members of the families Flaviviridae (e.g., West Nile virus [WNV]), Togaviridae (e.g., Eastern equine encephalitis virus), and Peribunyaviridae (e.g., La Crosse virus). Most of these viruses are zoonotic and are transmitted to humans through arthropods such as mosquitoes,”
§ Viral meningitis: an overview > Pathogenesis > Arboviruses
What the sources say
- Not checked — no full text of the sourcecites [94] Miller BR (2008) Arboviruses. In: Mahy BWJ, Van Regenmortel MHV (eds) Encyclopedia of virology (Third Edition). Academic Press, Oxford, pp 170–176 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Several studies have shown that pleconaril plays an important role in shortening the course of symptoms, especially headache [6, 99]. However, other studies have shown that there was no significant difference between treatment and placebo groups [100].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [6] Desmond R et al (2006) Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob Agents Chemother 50(7):2409–2414 source
- Not checked — no full text of the sourcecites [99] Romero JR (2001) Pleconaril: a novel antipicornaviral drug. Expert Opin Investig Drugs 10(2):369–379 source
- Not checked — no full text of the sourcecites [100] Abzug MJ et al (2003) Double blind placebo-controlled trial of pleconaril in infants with enterovirus meningitis. Pediatr Infect Dis J 22(4):335–341 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Collectively, this can explain the spread of influenza virus to the CNS, where it has the potential to cause various neurological syndromes, such as meningitis.”
§ Viral meningitis: an overview > Pathogenesis > Family Orthomyxoviridae
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“HPeV can be transmitted from person to person through respiratory secretions and saliva, leading primarily to respiratory infections [77].”
§ Viral meningitis: an overview > Pathogenesis > Family Picornaviridae
What the sources say
- Not checked — no full text of the sourcecites [77] Romero JR, Modlin JF (2015) 175—human parechoviruses. In: Bennett JE, Dolin R, Blaser MJ (eds) Mandell, Douglas, and Bennett's principles and practice of infectious diseases (Eighth Edition). Content Repository Only!: Philadelphia, pp 2091–2094.e2. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It is licensed as intranasal therapy for the common cold, but it attains several-fold higher concentrations in the CNS, making it a potential treatment for brain-related diseases such as meningitis [99].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [99] Romero JR (2001) Pleconaril: a novel antipicornaviral drug. Expert Opin Investig Drugs 10(2):369–379 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The use of acyclovir against HSV-2-induced meningitis was also evaluated, with better outcomes observed in treated patients. However, one patient developed concentration difficulties as a meningitis symptom that lasted for approximately three months [103].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [103] Bergström T, Alestig K (1990) Treatment of primary and recurrent herpes simplex virus type 2 induced meningitis with acyclovir. Scand J Infect Dis 22(2):239–240 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“No specific treatment is prescribed for aseptic meningitis cases, and supportive medications are usually given to minimize disease complications such as fever and headache, and full recovery takes from 5 to 14 days in the majority of cases [5].”
§ Viral meningitis: an overview > Management
What the sources say
- Not checked — no full text of the sourcecites [5] Kumar R (2005) Aseptic meningitis: diagnosis and management. Indian J Pediatr 72(1):57–63 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It often goes undetected or leads to a self-limited disease in adults. However, severe complications can develop in infants and children, including high fever, mental retardation, and even death in some cases.”
§ Viral meningitis: an overview > Conclusion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Viral meningitis is considered one of the most common clinical conditions affecting different age groups.”
§ Viral meningitis: an overview > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Molecular epidemiology studies of viral meningitis are scarce in many countries, including the MENA region.”
§ Viral meningitis: an overview > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Many viral causative agents are found to be associated with aseptic meningitis, such as enterovirus, parechovirus, and herpesviruses.”
§ Viral meningitis: an overview > Conclusion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper relies on this without support.
Findings from animal models and cell cultures used to describe viral meningitis pathogenesis are applicable to human disease.
“One study using a murine viral meningitis model in which mice were infected with lymphocytic choriomeningitis virus (LCMV) showed elevated levels of both IL-6 and INF-γ in CSF [50].”
“In addition, EV-D68 strains were able to infect and replicate in a human neuroblastoma cell line and a postnatal cortical neuron culture, but non-neurotropic strains were not [60].”
The paper relies on this without support.
Detection of viral nucleic acid in cerebrospinal fluid by PCR indicates that the detected virus is the cause of the meningitis.
“The gold standard tool for diagnosis of viral meningitis is the polymerase chain reaction (PCR), which detects and quantifies viral DNA or RNA in the patient’s CSF [41].”
“The most recently detected viral agent causing meningitis was reported in a case study of a 24-year-old male from Japan who had aseptic meningitis caused by SARS-CoV-2, which was demonstrated by performing an RT-PCR test on a CSF sample from the patient.”
The paper relies on this without support.
The cited epidemiological studies' case definitions and diagnostic methods are valid for estimating viral meningitis incidence and etiology.
“A study conducted in England between 2011 and 2014 showed that the incidence of viral meningitis was 2.73 per 100,000, with the largest number of cases caused by non-polio enteroviruses [8].”
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Metadata
- Authors
- Kohil, A., Jemmieh, S., Smatti, M. K., & Yassine, H. M.
- Affiliations
- Qatar University (QA)
- Corresponding author
- Yassine, Hadi M.
- Venue
- Archives of Virology
- Published
- 2021-01-03
- Volume
- 166
- Issue
- 2
- Pages
- 335-345
- ISSN
- 0003-9012 (ISSN-L)
- 0304-8608
- 1432-8798
- PMC
- PMC7779091
- OpenAlex
- W3118367501
- Cited by
- 164
- References
- 117
- Citations by year
- 2026: 29 · 2025: 35 · 2024: 40 · 2023: 34 · 2022: 20 · 2021: 5
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Archives of Virology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Qatar University QSpace (Qatar University) (submittedVersion)
- Funders
- Qatar University (QUST-2-BRC-2018-1, QUHI-BRC-20/21-1)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- viral meningitis, meningeal inflammation, enterovirus, herpesvirus, influenza virus, etiological agents, clinical features, diagnosis, pathogenesis, early diagnosis
- MeSH terms
- Animals, Humans, Meningitis, Viral, Viruses
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