Etiologies-aseptic meningitis

(Neurology 2006;66:75)

• Viral: enteroviruses are most common cause (summer/fall; rash, GI, URI sx), HIV, HSV, VZV, mumps (parotitis), lymphocytic choriomeningitis virus (rodent exposure), encephalitis viruses, adenovirus, polio, CMV, EBV, WNV
• Focal bacterial infection: brain/epidural/subdural abscess, CNS septic thrombophlebitis
• Partially treated bacterial meningitis
• Other infectious: TB, fungal (cryptococcus, coccidiodes), Lyme, syphilis, leptospirosis
• Neoplasm: intracranial tumors (or cysts), lymphomatous or carcinomatous meningitis
• Drug-induced meningitis: NSAIDs, IVIG, antibiotics (TMP-SMX, PCN), anti-epileptics
• Systemic autoimmune illness: SLE, sarcoidosis, Behçet’s, Sjögren’s syndrome, RA
• Mollaret’s: recurrent lymphocytic meningitis, spontaneously resolving (often HSV-2)