A87.0 Enteroviral meningitis

Name of the Condition

• Enteroviral meningitis

Summary

Enteroviral meningitis is an inflammation of the meninges, the protective membranes surrounding the brain and spinal cord, caused by enteroviruses. It is typically less severe than bacterial meningitis and often resolves without specific antiviral treatment. The condition presents with symptoms such as headache, fever, and neck stiffness, though outcomes are generally favorable with supportive care.

Causes

Enteroviral meningitis is caused by enteroviruses, which are transmitted through respiratory secretions or fecal-oral routes. Common enteroviruses include coxsackieviruses and echoviruses. The infection spreads when individuals come into contact with contaminated surfaces, fluids, or airborne particles from an infected person.

Risk Factors

• Close contact with individuals who have enteroviral infections.
• Weakened immune systems, including those with immunosuppressive conditions or therapies.
• Age, with infants and young children being more susceptible.
• Poor hygiene practices, such as inadequate handwashing.
• Living in or traveling to areas with high rates of enteroviral transmission.

Symptoms

• Sudden onset of fever and chills.
• Severe headache, often worse with movement.
• Stiff neck and sensitivity to light (photophobia).
• Nausea and vomiting.
• Altered mental status or confusion in severe cases.

Diagnosis

Diagnosis is based on clinical presentation, including symptoms like fever, headache, and neck stiffness, along with cerebrospinal fluid (CSF) analysis. CSF typically shows a lymphocytic predominance, normal or mildly elevated protein, and normal glucose levels. Polymerase chain reaction (PCR) testing of CSF or stool samples may confirm enteroviral infection.

Treatment Options

• Supportive care: Rest, hydration, and pain management (e.g., acetaminophen or ibuprofen) are primary.
• Antipyretics: Medications to reduce fever and alleviate discomfort.
• Hospitalization: May be required for severe cases or to monitor for complications.
• Antiviral therapy: Not routinely used, as most cases resolve spontaneously.

Prognosis and Follow-Up

Most individuals recover fully within 7–10 days with supportive care. Follow-up may involve monitoring for persistent symptoms or complications, such as viral encephalitis. Severe cases or those with underlying conditions may require longer recovery periods.

Complications

• Viral encephalitis (inflammation of the brain).
• Seizures.
• Hearing loss or other neurological deficits (rare).
• Recurrent meningitis in immunocompromised individuals.

Lifestyle & Prevention

• Practice good hand hygiene, especially after using the restroom or changing diapers.
• Avoid close contact with individuals showing signs of enteroviral infections (e.g., fever, rash).
• Ensure proper sanitation and hygiene in communal settings (e.g., schools, daycare centers).
• Stay up-to-date with vaccinations, as some enteroviruses (e.g., poliovirus) are preventable.

When to Seek Professional Help

Seek immediate medical attention if experiencing severe headache, neck stiffness, high fever, confusion, or signs of dehydration. These may indicate a more serious condition requiring urgent evaluation.

Tips for Medical Coders

Document the presence of enteroviral meningitis with the ICD-10-CM code A87.0. Ensure clinical documentation supports the diagnosis, including symptoms, CSF analysis, or viral testing. Differentiate from other causes of meningitis (e.g., bacterial) to avoid miscoding.