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Self-resolving viral meningitis in an adult male: a case report and review of the literature
Ali S.R.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
Viral meningitis is a self-limiting inflammatory condition of the meninges caused most commonly by enteroviruses, herpes simplex virus (HSV), and arboviruses. It is frequently associated with fever, headache, and nuchal rigidity. Although benign in immunocompetent individuals, the diagnosis necessitates clinical and laboratory evaluation scrutiny to exclude bacterial meningitis and other more sinister pathologies. A 47-year-old man with 7 days of progressive loss of consciousness preceded by fever and headache. Neurological examination yielded a score of E3M5V2 on the Glasgow Coma Scale (GCS) and positive nuchal rigidity. The cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, mildly elevated protein, and normal glucose concentrations, but it failed to identify any pathogen. The patient was treated symptomatically with intravenous fluids and additional supportive care. Over 2 weeks, it improved markedly, and he made a complete neurological recovery. Viral meningitis is the most frequent etiology of aseptic meningitis that must be differentiated from bacterial causes. Improved detection of viral pathogens and advanced diagnostic tools, such as polymerase chain reaction (PCR), have improved the diagnosis of diseases caused by viruses. Management is primarily supportive and includes antivirals for specific infections (e.g., HSV). We illustrate the common characteristics and course of self-limiting viral meningitis in immune-compromised patients and review the literature to support this. Self-limited viral meningitis poses a challenge for diagnosis, but with supportive therapy, it has an excellent prognosis. Timely diagnosis, treatment, and exclusion of bacterial meningitis are key in the management. Additional research is needed to consider optimal diagnostic and therapeutic strategies for viral meningitis.