Which clinical history findings are characteristic of enteroviral aseptic meningitis?

Updated: Mar 01, 2018
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Enteroviral infections (group B coxsackievirus and echovirus) account for 90% of cases of aseptic meningitis in patients younger than one year and 50% of cases in older children and adults. [43, 44]

The clinical presentations of aseptic meningitis vary greatly. Prodromal symptoms include fever, chills, headache, photophobia, and nuchal rigidity. Rash and upper respiratory tract symptoms may also occur. In infants, fever and irritability are the most common symptoms. [6]

Fever and meningeal signs subside within 2-7 days.

Enterovirus 71, which causes HFMD, has also been associated with a particularly more aggressive and, in some instances, fatal CNS infection in children. It manifests as flaccid motor paralysis and brain stem encephalitis. Large outbreaks were reported in the late 1990s in Eastern Europe, Russia, Thailand, and Taiwan. [45]

Most of the enterovirus-positive 758 children in a Korean outbreak experienced fever, headache, vomiting, and neck stiffness, although some also showed cold symptoms, sore throat, altered mental status, and seizures. [33] More than 80% of these had either echovirus types 6 or 30. The majority recovered uneventfully.


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