What causes aseptic meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Aseptic meningitis is one of the most common infections of the meninges. Unfortunately, up to 86% of cases of aseptic meningitis in adults have unknown causes, since molecular diagnostic techniques and arboviral serologies are underutilized. [7] If appropriate diagnostic methods are employed, a specific viral etiology is identified in 50-60% of cases of aseptic meningitis. However, aseptic meningitis can also be caused by bacteria, fungi, and parasites (see Table 1 below). It is noteworthy that partially treated bacterial meningitis accounts for a large number of meningitis cases with a negative microbiologic workup.

Table 1. Infectious Agents Causing Aseptic Meningitis (Open Table in a new window)

Category

Agent

Bacteria

Partially treated bacterial meningitis

Listeria monocytogenes

Brucella spp

Rickettsia rickettsii

Ehrlichia spp

Mycoplasma pneumoniae

Borrelia burgdorferi

Treponema pallidum

Leptospira spp

Mycobacterium tuberculosis

Nocardia spp

Parasites

Naegleria fowleri

Acanthamoeba spp

Balamuthia spp

Angiostrongylus cantonensis

Gnathostoma spinigerum

Baylisascaris procyonis

Strongyloides stercoralis

Taenia solium (cysticercosis)

Fungi

Cryptococcus neoformans

Coccidioides immitis

Blastomyces dermatitidis

Histoplasma capsulatum

Candida spp

Aspergillus spp

Viruses

Enterovirus

Poliovirus

Echovirus

Coxsackievirus A

Coxsackievirus B

Enterovirus 68-71

Herpesvirus (HSV)

HSV-1 and HSV-2

Varicella-zoster virus

Epstein-Barr virus

Cytomegalovirus

HHV-6 and HHV-7

Paramyxovirus

Mumps virus

Measles virus

Togavirus

Rubella virus

Flavivirus

West Nile virus

Japanese encephalitis virus

St Louis encephalitis virus

Bunyavirus

California encephalitis virus

La Crosse encephalitis virus

Alphavirus

Eastern equine encephalitis virus

Western equine encephalitis virus

Venezuelan encephalitis virus

Reovirus

Colorado tick fever virus

Arenavirus

LCM virus

Rhabdovirus

Rabies virus

Retrovirus

HIV

HHV = human herpesvirus; HSV = herpes simplex virus; LCM = lymphocytic choriomeningitis.

 

 

 

 


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