What Are the Treatments for Viral Meningitis?

Viral meningitis is now known as aseptic meningitis because treatment-specific causes are viral and non-viral. This condition is an infection of the meninges (lining of the brain and spinal cord) that causes inflammation. The two most common causes of viral meningitis are the echovirus and the coxsakie virus. According to the Centers for Disease Control and Prevention (CDC), people infected with these viruses have usually contracted them by touching fecal matter and then touching the mouth and nose, or by coming in contact with the respiratory droplets of an infected person. Several less common causes are listed below. Viral (aseptic) meningitis is usually milder than bacterial meningitis but can lead to complications if it is not treated properly.

Symptoms

Symptoms of viral meningitis include a stiff neck, headache, nausea and vomiting, lethargy, sore throat and chills. The health care provider will perform a spinal tap to collect and analyze spinal fluid. According to Dr. Tarakad S. Ramachandran, infected spinal fluid may contain decreased or normal glucose and increased protein.

Treatment

Treatment for viral meningitis caused by the coxsakie and echoviruses is supportive, meaning medication to control pain, dehydration, nausea and vomiting. Treatment for meningitis caused by herpes, chicken pox, tuberculosis, brucellosis, Lyme disease, rabies and fungal infections is listed below.

Herpes and Chicken Pox

Antivirals such as acyclovir are used to treat viral meningitis caused by herpes or chicken pox (Ramachandran, 2007). The usual meningitic dose of intravenous acylocvir is 10 milligrams/kilogram of weight every day for up to 21 days. Side effects can include abdominal pain, nausea and vomiting (Medscape Drug Reference).

Tuberculosis

Viral meningitis caused by tuberculosis is treated with an isoniazid-rifamp-pyrazinamide combination. (Ramachandran, 2007) The usual dosage is six tablets every day. Side effects include joint pain, abdominal pain and discolored urine, sweat and feces (Medscape Drug Reference).

Brucellosis

Brucellosis is contracted from domesticated animals such as dogs, cats, sheep, cows and goats. It is treated with doxycycline or rifampin (Ramachandran, 2007). Doxycycline may be taken orally or intravenously. The recommended dose of doxycycline is 200 milligrams every day or 100 milligrams twice a day. Side effects include discoloration of the teeth. Rifampin may also be taken orally or intravenously. The recommended intravenous dose of rifampin is 600 milligrams twice a day for two days or 600 milligrams once a day for four days. Side effects include abdominal pain and discolored urine, sweat and feces (Medscape Drug Reference).

Lyme Disease

Viral meningitis caused by Lyme disease is treated with penicillin or ceftriaxone (Ramachandran, 2007). The recommended dose of intravenous penicillin is up to 3 million units every four to six hours. The recommended dose of ceftriaxone is two grams intravenously every 12 hours for up to seven days. Side effects can include diarrhea, nausea and vomiting, and headache (Medscape Drug Reference).

Rabies

The usual dose of gentamicin for meningitis caused by rabies is 1 milligram per kilogram of weight every eight hours. Side effects include kidney disease, ear damage and central nervous system damage (Medscape Drug Reference).

References

• Non-Polio Enterovirus Infections, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases
• Aseptic Meningitis, Tarakad S. Ramachandran, MD, Chief, Department of Neurology, Crouse Irving Memorial Hospital; Professor, Department of Neurology, State University of New York Upstate Medical University, Nov. 29, 2007
• Medscape Drug Reference

Resources

• Medscape Drug Reference