Case history

Case history #1

A 19-year-old man presents with a 2-day history of headache and associated nausea. He says that bright light hurts his eyes. He has no significant past medical history, is not currently taking any medication, and reports no drug allergies. He works as a librarian and has not traveled overseas for the past year. He lives with his girlfriend whom he has been seeing for 2 years. They have a pet hamster.

Case history #2

Parents bring their 2-year-old child who has been ill for 1 day with irritability, vomiting, and fever. The child has a widespread maculopapular rash.

Other presentations

The symptoms and signs of viral meningitis are similar to those of bacterial meningitis, and it may be impossible to differentiate the two conditions clinically.[1] For detailed information on bacterial meningitis, see Bacterial meningitis in adults and Meningococcal disease.

Headache and fever are typically prominent.[2][3] Patients may also complain of photophobia, neck stiffness, and nausea.[4] Other nonspecific symptoms such as diarrhea and vomiting, myalgia, and sore throat can also occur.[3] There may be an associated rash. In young children, presentation may be nonspecific and meningitis may not be suspected.[5] Children may also present with seizures and this does not necessarily indicate the presence of encephalitis. Mollaret meningitis is a benign recurrent meningitis thought to be caused by HSV-2.

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