Aseptic meningitis refers to meningitis that is not accompanied by bacterial growth on cultures taken from the cerebrospinal fluid. According to Merck.com, the most common cause is viral infection. Partially treated bacterial infections, and bacteria such as syphilis and Lyme, can also cause aseptic meningitis. Other causes include medications, reactions to immunizations and cancer.
Headache and Photophobia
Meningitis means inflammation of the meninges, which are the tissues surrounding the brain. Symptoms of aseptic meningitis are similar to those of bacterial meningitis, but are usually much milder, and evolve over several days. Symptoms of meningeal irritation include headaches, photophobia and neck stiffness. Many viral illnesses cause headache; according to "Adam's and Victor's Principles of Neurology," the headache in aseptic meningitis is more severe. Photophobia, meaning an aversion to light, causes patients to prefer a darkened room. Eye movements can cause pain. Neck stiffness, a common symptom of meningitis, can be very mild in aseptic meningitis. Brudzinski's neck sign is part of the physical exam that tests for neck stiffness; when the physician bends the patient's neck forward, his hips and knees flex.
Other Neurological Symptoms
Accompanying neurological symptoms vary greatly depending on the causative agent. Lyme disease can cause cranial neuropathies. Syphilis can damage the blood vessels in the brain, as well as grow into defined collections known as gumma. According to 'Harrison's Principles of Internal Medicine," confusion, hallucinations, seizures and a decreased level of consciousness can occur with aseptic meningitis, though usually the disease follows a mild course with few neurological complications.
Systemic Symptoms
Aseptic meningitis can be accompanied by many systemic symptoms, meaning symptoms that affect the entire body. Fever may be the first symptom. Sometimes it appears, then remits, only to reappear along with the signs of meningeal irritation. Nausea and vomiting are common. According to "Harrison's Principles of Internal Medicine," a rash sometimes accompanies viral meningitis. Its appearance can indicate which specific virus caused the illness. Autoimmune diseases, such as systemic lupus erythematosus,or SLE, have many systemic manifestations that can accompany meningitis, including rash, joint pain and renal disease. Flare-ups of autoimmune diseases often involve several organs; when typical symptoms of another disease accompany meningitis, these diseases should be considered in the differential diagnosis.
References
- Merck: Aseptic Meningitis
- "Adam's and Victor's Principles of Neurology"; Raymond Adams, Maurice Victor and Allan Ropper; 2001
- "Harrison's Principles of Internal Medicine, 17th Edition"; Antoni Fauci, Editor; 2008
