Table 2.
Clinical features of adults with viral meningitis
| Clinical features | All viral meningitisa | Confirmed viral meningitis | EVs | HSV-2 | VZV | Miscellaneous viruses | Unidentified pathogen |
|---|---|---|---|---|---|---|---|
| n = 1066 | n = 783 | n = 419 | n = 171 | n = 162 | n = 31 | n = 283 | |
| Age, years | 33 (27–44) | 33 (27–43) | 32 (28–35) | 36 (27–49) | 46 (27–69) | 41 (27–51) | 33 (26–46) |
| Sex, female | 576/1066 (54) | 419/783 (54) | 195/419 (47) | 131/171 (77) | 81/162 (50) | 12/31 (39) | 157/283 (55) |
| Full-time occupation | 852/1023 (83) | 630/747 (84) | 380/405 (94) | 128/162 (79) | 95/151 (63) | 27/29 (93) | 222/276 (80) |
| Immunosuppression | 83/1066 (8) | 62/783 (8) | 11/419 (3) | 13/171 (8) | 32/162 (20) | 6/31 (19) | 21/283 (7) |
| Duration of symptoms, days | 2 (1–5) | 2 (1–4) | 2 (1–3) | 1 (1–3) | 4 (2–6) | 5 (3–14) | 3 (1–6) |
| Prodromal gastrointestinal symptoms | 133/991 (13) | 96/722 (13) | 66/385 (17) | 13/158 (8) | 12/152 (8) | 5/27 (19) | 37/269 (14) |
| Prodromal airway symptoms | 141/985 (14) | 94/718 (13) | 60/384 (16) | 18/157 (11) | 15/150 (10) | 1/27 (4) | 47/267 (18) |
| Shingles | 104/897 (12) | 100/670 (15) | 4/350 (1) | 6/145 (4) | 90/149 (60) | 0/26 (0) | 4/227 (2) |
| GCS score <15b | 65/1029 (6) | 40/755 (5) | 13/401 (3) | 8/168 (5) | 19/157 (12) | 0/29 (0) | 25/274 (9) |
| History of fever | 691/971 (71) | 522/707 (74) | 308/379 (81) | 113/153 (74) | 77/146 (53) | 24/29 (83) | 169/264 (64) |
| Temperature ≥38°C | 432/1031 (42) | 337/763 (44) | 198/409 (48) | 75/167 (45) | 51/159 (32) | 13/28 (46) | 95/268 (35) |
| Headache | 1005/1061 (95) | 740/780 (95) | 414/418 (99) | 161/170 (95) | 139/162 (86) | 26/30 (87) | 265/281 (94) |
| Hyperacusis or photophobia | 660/987 (67) | 508/721 (70) | 303/394 (77) | 120/157 (76) | 73/146 (50) | 12/24 (50) | 152/266 (57) |
| Neck stiffness | 371/1028 (36) | 299/755 (40) | 156/408 (38) | 92/162 (57) | 42/156 (27) | 9/29 (31) | 72/273 (26) |
| Triad of signs and symptomsc | 264/960 (28) | 215/702 (31) | 118/385 (31) | 68/151 (45) | 24/143 (17) | 5/23 (22) | 49/258 (19) |
| ≥2 signs and symptomsd | 835/955 (87) | 624/698 (89) | 361/383 (94) | 138/150 (92) | 105/142 (74) | 20/23 (87) | 211/257 (82) |
| Blood leucocytes, cells × 109/l | 8.3 (6.6–10.4) | 8.2 (6.6–10.1) | 8.5 (6.9–10.1) | 8.4 (6.9–10.5) | 7.7 (6.2–9.5) | 8.1 (6.4–10.8) | 8.8 (6.6–11.2) |
| C-reactive protein, mg/l | 5 (2–15) | 5 (2–13) | 8 (3–17) | 3 (1–6) | 3 (1–8) | 6 (3–30) | 4 (1–25) |
| CSF leucocyte count, cells/µl | 160 (60–358) | 180 (68–417) | 135 (59–278) | 374 (162–670) | 233 (76–443) | 104 (35–296) | 117 (42–234) |
| CSF neutrophil percentage | 7 (1–31) | 8 (1–30) | 24 (6–55) | 3 (1–9) | 1 (0–4) | 4 (0–19) | 4 (0–33) |
| CSF to blood glucose ratio | 0.55 (0.48–0.62) | 0.54 (0.48–0.61) | 0.57 (0.51–0.62) | 0.52 (0.45–0.57) | 0.50 (0.45–0.57) | 0.54 (0.48–0.61) | 0.58 (0.52–0.64) |
| CSF lactate, mmol/l | 2.3 (2.0–2.8) | 2.4 (2.1–2.9) | 2.2 (2.0–2.6) | 3.1 (2.6–3.9) | 2.5 (2.2–3.0) | 2.3 (1.8–2.9) | 2.0 (1.7–2.4) |
| CSF protein, g/l | 0.70 (0.50–1.00) | 0.73 (0.51–1.07) | 0.60 (0.48–0.78) | 1.10 (0.78–1.50) | 1.00 (0.67–1.49) | 0.80 (0.50–1.38) | 0.59 (0.44–0.82) |
Quantitative data are presented as median (IQR) and categorical data are presented as n/N (%).
Including presumed viral meningitis without an identified pathogen.
Glasgow Coma Scale (GCS) score <15 for <24 h.
Triad of headache, neck stiffness and hyperacusis or photophobia.
Signs and symptoms were headache, neck stiffness, hyperacusis or photophobia and a history of fever or measured fever.