ArticleBrain : a journal of neurology2023
Clinical features and prognostic factors in adults with viral meningitis.
Article in Brain : a journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 37 citations in OpenAlex.
- New Insights Into the Therapeutic Management of Varicella Zoster Virus Meningitis: A Series of 123 Polymerase Chain Reaction-Confirmed Cases.Open forum infectious diseases · 2024Trial
- Article
- Prognostic Factors and Clinical Characteristics of Varicella Zoster Virus Meningitis: Impact of Treatment Delay and Age-Related Differences in a Japanese Tertiary Hospital.Neurology international · 2026Article
- Varicella zoster virus and the central nervous system.Nature reviews. Microbiology · 2026Review
- Clinical epidemiology, determinants, and outcomes of severe viral encephalitis in Chinese children: a multicenter retrospective cohort study.BMC infectious diseases · 2026Article
- S1 guidelines of the German Society of Neurology for Viral Meningoencephalitis- AWMF Registration No.: 030-100.Neurological research and practice · 2026Article
- Human herpesvirus 7 induced aseptic meningitis in an immunocompetent adult presenting with unusual neurological symptoms: a case report.Virology journal · 2025Article
- A prognostic model for early risk stratification in adult community-acquired suspected CNS infections: multicenter development and external validation.BMC infectious diseases · 2025Article
- Article
- [Management of acute community-acquired bacterial meningitis : Leading symptoms of impaired consciousness and fever with/without headache].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Incidence and Risk Factors for Varicella-Zoster Virus-Associated Central Nervous System Infections: A Nationwide Swedish Retrospective Case-Control Study.Journal of medical virology · 2025Article
- Varicella-zoster virus meningitis with hypoglycorrhachia, presenting with painless occipital herpes zoster mimicking atopic dermatitis.BMJ case reports · 2025Article
- Are Glucocorticoids Truly Effective in Improving the Clinical Prognosis of HSV-1 Encephalitis?Infection and drug resistance · 2025Article
- Nanotechnology-powered Meningitis Therapies: Lipid Nanoparticles Lead the Way.Current pharmaceutical biotechnology · 2025Review
- Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections.Clinical microbiology reviews · 2024Review
- Viral Etiology of Aseptic Meningitis and Clinical Prediction of Herpes Simplex Virus Type 2 Meningitis.Journal of personalized medicine · 2024Article
- Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021.JAMA network open · 2024Article
- Benign recurrent lymphocytic meningitis (Mollaret's meningitis) in Denmark: a nationwide cohort study.European journal of neurology · 2024Article
- Long-term sequelae after viral meningitis and meningoencephalitis are frequent, even in mildly affected patients, a prospective observational study.Frontiers in neurology · 2024Article
- Meningitis in Niger Republic amidst COVID-19: current issues and novel recommendations.Annals of medicine and surgery (2012) · 2024Review
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clinical features applicable to the entire spectrum of viral meningitis are limited, and prognostic factors for adverse outcomes are undetermined. This nationwide population-based prospective cohort study included all adults with presumed and microbiologically confirmed viral meningitis in Denmark from 2015 until 2020. Prognostic factors for an unfavourable outcome (Glasgow Outcome Scale score of 1-4) 30 days after discharge were examined by modified Poisson regression. In total, 1066 episodes of viral meningitis were included, yielding a mean annual incidence of 4.7 episodes per 100 000 persons. Pathogens were enteroviruses in 419/1066 (39%), herpes simplex virus type 2 in 171/1066 (16%), varicella-zoster virus in 162/1066 (15%), miscellaneous viruses in 31/1066 (3%) and remained unidentified in 283/1066 (27%). The median age was 33 years (IQR 27-44), and 576/1066 (54%) were females. In herpes simplex virus type 2 meningitis, 131/171 (77%) were females. Immunosuppression [32/162 (20%)] and shingles [90/149 (60%)] were frequent in varicella-zoster virus meningitis. The triad of headache, neck stiffness and hyperacusis or photophobia was present in 264/960 (28%). The median time until lumbar puncture was 3.0 h (IQR 1.3-7.1), and the median CSF leucocyte count was 160 cells/µl (IQR 60-358). The outcome was unfavourable in 216/1055 (20%) 30 days after discharge. Using unidentified pathogen as the reference, the adjusted relative risk of an unfavourable outcome was 1.34 (95% CI 0.95-1.88) for enteroviruses, 1.55 (95% CI 1.00-2.41) for herpes simplex virus type 2, 1.51 (95% CI 0.98-2.33) for varicella-zoster virus and 1.37 (95% CI 0.61-3.05) for miscellaneous viruses. The adjusted relative risk of an unfavourable outcome was 1.34 (95% CI 1.03-1.75) for females. Timing of acyclovir or valacyclovir was not associated with the outcome in meningitis caused by herpes simplex virus type 2 or varicella-zoster virus. In summary, the outcome of viral meningitis was similar among patients with different aetiologies, including those with presumed viral meningitis but without an identified pathogen. Females had an increased risk of an unfavourable outcome. Early antiviral treatment was not associated with an improved outcome in meningitis caused by herpes simplex virus type 2 or varicella-zoster virus.
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