title: Viral meningitis: current issues in diagnosis and treatment.
abstract: OBJECTIVE
  The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome.
  
  
  RESULTS
  Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions. Despite improvements in diagnostics many laboratories do not use molecular methods and even when they are used many cases still remain without a proven viral aetiology identified. There are also no established treatments for viral meningitis and the one potential treatment, aciclovir, which is effective in vitro for herpes simplex virus, has never been subjected to a clinical trial.
  
  
  CONCLUSIONS
  Viruses are in increasingly important cause of meningitis in the era of declining bacterial disease. The exact viral aetiology varies according to age and country. Molecular diagnostics can not only improve the rate of pathogen detection but also reduce unnecessary antibiotics use and length of hospitalization. Further research is required into treatments for viral meningitis and the impact in terms of longer term sequelae.
authors.affiliation: aInstitute of Infection and Global Health, University of Liverpool bNational Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections, University of Liverpool cRoyal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool dLeeds Teaching Hospitals NHS Trust, Leeds eAlderhey Children's NHS Foundation Trust fThe Walton Centre NHS Foundation Trust, Liverpool, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: McGill
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Griffiths
authors.forename: Tom
authors.initials: T
authors.lastname: Solomon
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000494:pharmacology; D006801:Humans; D015994:Incidence; D016920:Meningitis, Bacterial / Q000453:epidemiology; D008587:Meningitis, Viral / Q000175:diagnosis* / Q000188:drug therapy*; D025202:Molecular Diagnostic Techniques; D018139:Simplexvirus / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir