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Other viral infections are acquired by breathing air contaminated with virus-containing droplets exhaled by an infected person.Arbovirus infections are acquired from bites by infected insects (called epidemic encephalitis).In viral infections, the number of white blood cells is increased in the CSF, but no bacteria are seen.Immunologic tests that detect antibodies against viruses in samples of CSF may be done, but these tests usually take days to complete.The symptoms and treatment of viral meningitis and of encephalitis in older children and adolescents are similar to those in adults.The inability of infants to communicate directly makes it difficult to understand their symptoms.Polymerase chain reaction (PCR) techniques are available to more quickly identify herpes simplex virus and enteroviruses in the CSF.A test of brain waves (electroencephalography) can be used to help diagnose encephalitis caused by herpesvirus.
Infants older than a month or so typically become irritable and fussy and refuse to eat. Sometimes the soft spot on top of a newborn's head (fontanelle) bulges, indicating an increase in pressure on the brain.
Without treatment, about 50% of newborns with herpes simplex infection of the brain die, and two thirds of those who survive have severe brain damage.
Even with treatment, about 25% die and up to half of the survivors have brain damage.
Doctors are concerned about the possibility of meningitis or encephalitis in every newborn who has a fever, as well as in older infants, children, and adolescents who have fever and are irritable or otherwise not acting normally.
To make the diagnosis of meningitis or the diagnosis of encephalitis, doctors do a spinal tap (lumbar puncture) to obtain cerebrospinal fluid (CSF) for laboratory analysis.
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Caserta, MD, Professor of Pediatrics, Division of Infectious Diseases; Attending Physician, University of Rochester School of Medicine and Dentistry; Golisano Children’s Hospital at Strong, University of Rochester Medical Center Children acquire infections of the central nervous system through various routes.