Aseptic Meningitis: Course and Prognosis

Clinical Presentation and Etiology

Aseptic meningitis typically presents with meningism (neck stiffness, headache and photophobia), though fever is not always present, according to the Journal of Infection 2
The most common viral etiologies in adults include Enteroviruses, Herpes simplex virus type 2 (HSV-2), and Varicella zoster virus (VZV), as reported by the Journal of Infection 2
Viral causes account for 50-80% of aseptic meningitis cases, as stated by the Journal of Infection 2

Mortality is rare in immunocompetent adults with viral meningitis, according to the Journal of Infection 1
Headaches are frequently reported as a long-term sequela, occurring in up to one-third of patients, as reported by the Journal of Infection 1
Other potential long-term issues include fatigue and sleep disorders, emotional difficulties and psychological impacts, cognitive deficits, arthritis, limb pain, muscle pain, and neuropathic pain, as stated by the Journal of Infection 1

Recurrent episodes of lymphocytic meningitis (Mollaret's meningitis) can occur, most often caused by HSV-2, as reported by the Journal of Infection 3
All patients should be assessed for potential long-term sequelae, both physical and psychological, before discharge from hospital, according to the Journal of Infection 1
Follow-up care is important, as many issues may only become apparent after discharge, as stated by the Journal of Infection 1
Underestimating the psychological impact and need for support during recovery can be a common pitfall, as reported by the Journal of Infection 1
Inadequate follow-up care, such as not routinely offering follow-up where needed, can also be a common pitfall, as stated by the Journal of Infection 1
Premature return to full activities before complete recovery can be a common pitfall, as reported by the Journal of Infection 1