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Cited by 92Infectious Encephalopathies and EncephalitisViral Infections and Immunology ResearchBacterial Infections and Vaccines

Etiologies and management of aseptic meningitis in patients admitted to an internal medicine department

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Jarrin, Irène, Sellier, Pierre, Lopes, Amanda, Morgand, Marjolaine, Makovec, Tamara, Delcey, Veronique, Champion, Karine, Simoneau, Guy +4 more·2016·Medicine
DOI 10.1097/md.0000000000002372PMC PMC4718237
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Abstract

Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or inflammatory diseases could also be distinguished according to several clinical and biological characteristics highlighted in this retrospective study. As recommendations are now available concerning the prescriptions of antiviral agents in viral meningitis, better therapeutic management is expected in the future.

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  • The viral etiology of the majority of aseptic meningitis cases is unknown.

    “Importantly, the viral etiology of the majority of aseptic meningitis cases is unknown (9–11).”

    From Viruses Causing Aseptic Meningitis: A Tertiary Medical Center Experience With a Multiplex PCR Assay (2020) · cites this paper as [10]

    The Abstract reports that 97 of 180 aseptic meningitis cases lacked a definitive etiological diagnosis, supporting the claim that the cause was unknown in a majority of this cohort. It does not establish that those undiagnosed cases were viral. The Introduction also gives a broader diagnostic range of 30%–65%, which does not consistently imply an unknown cause in the majority of cases. (LLM, conf=0.84)

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1 retracted

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Research works printed but not linked: 1

  1. [14]Stahla JP Mailles A Vaillant V et le comité de pilotage du protocole encéphalite. Acute infectious encephalitis: guidelines for etiological diagnosis. Reanimation 2007; 16: 485– 489.

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Authors
Jarrin, I., Sellier, P., Lopes, A., Morgand, M., Makovec, T., Delcey, V., Champion, K., Simoneau, G., Green, A., Mouly, S., Bergmann, J.-F., & Lloret-Linares, C.
Affiliations
Assistance Publique – Hôpitaux de Paris (FR)
Corresponding author
Jarrin, Irène
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-01
Volume
95
Issue
2
Pages
e2372
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000002372
PMC
PMC4718237
OpenAlex
W2282056553
Cited by
92
References
34
Citations by year
2026: 3 · 2025: 8 · 2024: 8 · 2023: 8 · 2022: 5 · 2021: 12 · 2020: 9 · 2019: 14 · 2018: 15 · 2017: 9 · 2016: 1
FWCI
12.01
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
aseptic meningitis, encephalitis, etiology, enterovirus, herpes simplex virus type 2, varicella-zoster virus, inflammatory diseases, cerebrospinal fluid PCR, antiviral therapy, antibiotic therapy, treatment outcomes, adults
MeSH terms
Adult, Encephalitis, Enterovirus, Female, Hospital Departments, Humans, Internal Medicine, Male, Meningitis, Aseptic, Middle Aged, Retrospective Studies, Herpesvirus 3, Human, Herpesvirus 2, Human, Young Adult

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