Acute lymphocytic choriomeningitis occurs sporadically and has almost the same clinical picture as of bacterial meningitis though the course generally is less fulminant.
The disease is caused by a filterable virus which has been recovered from the CSF of patients. It is an Arena virus which is an RNA virus seen in mice and monkeys. A large number of other viruses like Echoviruses, Coxsackie, Epstein bar, Herpes simplex type-I and Mumps virus have also been isolated in these cases though it is difficult to document them in all cases.
There is intense lymphocytic infiltration of the lepatomeninges along with degeneration of the ganglion cells. Cytoplasmic inclusion bodies may be seen.
Onset is abrupt with high fever, toxemia, irritability, photo phobia and features of meningeal irritation, Neck rigidity is only slight. Fever comes down by lysis in about a weeks time.
Lymphocytic choriomeningitis has to be differentiated from tubercular and pyogenic meningitis. CSF in this case is under pressure, clear and rarely turbid. Protein content is raised but sugar and chloride content of CSF is normal. There is excess of cells mainly mono nuclear, count ranging from 100 to 1000 cells per cmm.
Acute lymphocytic choriomeningitis is a self-limiting disease. Treatment mainly is supportive in the form of maintaining nutrition, hydration and electrolyte balance. No specific drug is indicated but if secondary infection is suspected a cover of broad spectrum antibiotics (Injection Ampicillin 500 mg IN 6 hourly) may be given.
Since recovery from the condition is good and there are none of the life threatening complications as associated with pyogenic meningitis, prognosis is most of the cases is good though recovery may be slow.
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