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Herpes meningitis is typically self-limiting over 2 weeks without treatment. However, empirical use of antiviral medications such as acyclovir are considered in cases of suspected HSV meningitis to prevent progression to the more rapid and fatal HSV meningoencephalitis. [7] HSV-2 is the most common herpes virus that causes meningitis. [3]
The initial test is usually a lumbar puncture to collect cerebrospinal fluid for analysis. The lumbar puncture in chronic meningitis usually shows a lymphocytic predominant inflammatory pattern, however, some infectious agents such as early tuberculosis meningitis, nocardia or brucella may have an neutrophilic predominant inflammation. [2]
A cerebrospinal fluid sample is taken by lumbar puncture and is tested for leukocyte levels to determine if there is an infection and goes on to further testing to see what the actual cause is. The symptoms are the same for both meningitis and aseptic meningitis but the severity of the symptoms and the treatment can depend on the certain cause.
Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. [2] [8] A lumbar puncture, in which a needle is inserted into the spinal canal to collect a sample of cerebrospinal fluid (CSF), can diagnose or exclude meningitis. [1] [8]
A lumbar puncture can give the symptom of a post-dural-puncture headache. A cerebrospinal fluid leak can be either cranial or spinal, and these are two different disorders. [5] A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak.
Lumbar puncture would be performed to collect cerebral spinal fluid (CSF) to culture for bacterial growth. Growth indicated a bacterial meningitis, while no growth indicated another cause denoted "aseptic" meningitis. [1] The most common form of this is viral meningitis. [1]
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