Meningitis is an acute inflammation of the meninges, protective membranes covering the brain and spinal cord. Symptoms in adults include headache, fever and neck stiffness, as well as sometimes confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Children often show only nonspecific symptoms, such as irritability or drowsiness.
The most common cause is infection with viruses including enteroviruses, herpes simplex virus (mainly HSV-2), varicella zoster virus, mumps virus, HIV and lymphocytic choriomeningitis. In Western countries, viral meningitis occurs in around 11 people per 100,000 each year. Infection with bacteria, fungi, protozoa and parasites can also cause meningitis, and there are several non-infectious causes. Although some forms of meningitis can be life-threatening, viral meningitis is generally more benign than that caused by bacterial infection. It usually resolves spontaneously and is rarely fatal. HSV-2 can cause a chronic, recurrent form called Mollaret's meningitis.
Polymerase chain reaction of cerebrospinal fluid and identification of antibodies can be used to differentiate between viral causes. Viral meningitis typically only requires supportive therapy; meningitis caused by HSV or varicella zoster virus sometimes responds to treatment with antiviral drugs such as aciclovir. Mumps-associated meningitis can be prevented by vaccination.