Pathogenesis (development of disease)
In viral meningitis, there is predominantly only irritation of the meninges (structured layers of connective tissue that enclose the brain and spinal cord like a protective shell and), possibly also meningoencephalitis (combined inflammation of the brain (encephalitis) and meninges (meningitis)).
Viral meningitis often occurs in conjunction with another viral disease (e.g., parotitis epidemica (mumps), TBE, etc.).
Most commonly, viral meningitis is caused by adenoviruses.
Etiology (causes)
Disease-related causes.
Viral infection, especially with:
- Adenoviruses
- Arboviruses such as flaviviruses
- Enteroviruses such as coxsackie or echoviruses (e.g., echovirus 30, which can cause aseptic meningitis)
- TBE virus from the Flaviviridae family.
- Hanta virus
- Herpes virus (herpes simplex)
- HIV
- Lymphocytic chorionic meningitis virus (LCMV).
- Measles virus
- Mumps virus
- Phlebo virus*
- Poliomyelitis virus
- Varicella zoster virus (VZV)
- Meningoencephalitis (combined inflammation of the brain (encephalitis) and meninges (meningitis)) caused by varicella zoster virus (VZV) associated with fingolimod.
- Rare causative agents of viral meningoencephalitis that are never or only sporadically found in Western countries.
- Ebola virus is a genus of the family Filoviridae.
- Japanese encephalitis B virus (JEV) from the flavivirus family.
- Lassa virus
- Nipah virus of the paramyxovirus family.
- West Nile virus (WNV)
- Rabies virus (rabies) from the genus Lyssaviruses of the family Rhabdoviridae.
- Tuscany virus (phleboviruses).
- Zika virus (ZIKV).
* Sandfly fever virus (SFV): phleboviruses; transmission: bite of sandflies of the genus Phlebotomus (P. perniciosus, P. perfiliewi)Occurrence: European Mediterranean (29 different species of sandflies); North and East Africa, Near and Middle East, Southeast Asia, India, Central and South AmericaIncubation period: a few daysClinical presentation: 1st phase: sudden onset of high fever up to 41 °C, frontal headache (forehead pain). Phase: sudden onset of high fever up to 41°C, frontal headache, retrobulbar pain and conjunctivitis, myalgia and arthralgia (especially lumbosacral/lower back pain). lumbosacral/lumbar spine and sacrum), upper abdominal discomfort and gastrointestinal discomfort/gastrointestinal discomfort; marked lassitude and fatigue; relative bradycardia (heartbeat too slow: < 60 beats per minute) is typical (duration of first phase: approx. 2-4 days);2nd phase (due to neutrophilic activity of the virus): after a brief improvement of the initial symptoms: neurological complications with aseptic meningitis (meningitis), encephalitis (brain inflammation) and meningoencephalitis; usually from healing of the disease without consequences, possibly Also occurrence of hepatitis (liver inflammation)Laboratory diagnosis: detection: detection of specific IgM and IgG antibodies against sandfly fever virus in serum by immunoblot Leukopenia (reduction of white blood cells), occasionally also thrombocytopenia (reduction of platelets); elevation of transaminases, creatine kinase (CK) and alkaline phosphatase (AP).