When is viral meningitis treated in an outpatient setting?

Updated: Jul 17, 2018
  • Author: Cordia Wan, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Although most patients with signs of meningitis are hospitalized, a subgroup with aseptic meningitis is treated appropriately in an ambulatory setting. Absolute criteria for discharge of these patients from the emergency department (ED) have not been established, but investigations in children suggest that age greater than 1 year, nontoxic clinical appearance, normal serum WBC count, mild CSF pleocytosis, negative CSF Gram stain, adequate control of symptoms, and a reliable family setting may serve as some useful factors in the decision to discharge.

Prospective studies would aid in further delineating guidelines for patient discharge and follow-up. Most admissions are for IV hydration, empiric antibiotics, and observation, or they occur if a diagnosis other than viral meningitis is being considered.


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