A87.1 Adenoviral meningitis

Name of the Condition

• Adenoviral meningitis

Summary

Adenoviral meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord, caused by adenovirus infections. 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

Adenoviral meningitis is caused by adenoviruses, which are transmitted through respiratory droplets, fecal-oral routes, or contact with contaminated surfaces. These viruses can infect the respiratory tract, eyes, or gastrointestinal system before spreading to the meninges. The infection spreads when individuals come into contact with infected secretions or contaminated objects.

Risk Factors

• Close contact with individuals who have adenoviral infections (e.g., in households or schools).
• 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 adenoviral 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.
• Fatigue or lethargy.

Diagnosis

Adenoviral meningitis is diagnosed through a combination of clinical evaluation and laboratory testing. Cerebrospinal fluid (CSF) analysis may show elevated white blood cells, and viral PCR testing can confirm adenovirus presence. Imaging studies like MRI or CT scans may be used to rule out other causes of meningitis.

Treatment Options

• Supportive Care: Rest, hydration, and over-the-counter pain relievers (e.g., acetaminophen) to manage symptoms.
• Antiviral Therapy: Not typically required, as the condition often resolves on its own.
• Hospitalization: May be necessary for severe cases to monitor and manage complications.

Prognosis and Follow-Up

Most individuals with adenoviral meningitis recover fully within 1-2 weeks with supportive care. Follow-up care may include monitoring for persistent symptoms or complications, especially in immunocompromised patients. Long-term sequelae are rare but possible in severe cases.

Complications

• Seizures or neurological deficits.
• Prolonged headache or fatigue.
• Rarely, severe cases may lead to encephalitis or other neurological complications.

Lifestyle & Prevention

• Practice good hand hygiene, especially after coughing or sneezing.
• Avoid close contact with individuals showing signs of respiratory or gastrointestinal illness.
• Disinfect frequently touched surfaces regularly.
• Stay up-to-date with adenovirus vaccinations if recommended (e.g., for military personnel or high-risk groups).

When to Seek Professional Help

Seek immediate medical attention if symptoms worsen or include severe headache, neck stiffness, confusion, or difficulty breathing. Prompt evaluation is important to rule out bacterial meningitis or other serious conditions.

Tips for Medical Coders

When coding for adenoviral meningitis (A87.1), ensure documentation supports the diagnosis, including clinical findings (e.g., CSF analysis, viral testing) and exclusion of other causes. Verify that the code aligns with the specific viral etiology and clinical presentation.