How is aseptic meningitis treated?

Updated: Jul 17, 2018
  • Author: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Many patients who have aseptic meningitis can be cared for on an outpatient basis, but those who have profound headache, nausea, vomiting, or CSF pleocytosis with a polymorphonuclear leukocyte predominance should be admitted for observation. Antibiotic coverage for bacterial meningitis may be given, at the discretion of the managing clinician.

No specific treatment exists for most of the viruses that cause meningitis; therefore, management, for the most part, is supportive and includes analgesics, antinausea medications, intravenous fluids, and prevention and treatment of complications.

Headache and fever usually can be treated with judicious doses of acetaminophen. Severe hyperthermia (>40°C) may require vigorous therapy, but mild temperature elevation may serve as a natural defense mechanism, and some authors believe it should be left untreated.

Strict isolation is not necessary. When enteroviral infection is suspected, take precautions in handling stools and wash hands carefully. In patients with meningitis from measles, chickenpox, rubella, or mumps virus infections, the usual precaution of isolation from susceptible individuals should be observed.

For severe cases, meticulous care in an intensive care setting with respiratory and nutritional support is warranted. Remarkable recovery may be achieved in some patients who become comatose. Vigorous support and avoidance of complications are very important in these patients.


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