Humans are the only known reservoir for enteroviruses, and transmission of enteroviruses occurs most commonly by the fecal-oral route, leading to aseptic meningitis.
Primary Herpes simplex virus (HSV) has been increasingly recognized as a cause of viral meningitis in adults. Viral meningitis in immunocompetent adults is generally caused by HSV-2. Genital lesions are present in approximately 85 percent of patients with primary HSV-2 meningitis, and these generally precede the onset of CNS symptoms by seven days.
Meningitis due to N. meningitidis tends to strike young, previously well individuals and can progress over a matter of hours to death. The organism is considered a respiratory pathogen and spread is most likely by the aerosol route. It seen more often in less well-developed countries.
S. pneumoniae is the leading cause of bacterial meningitis in adults in the USA. This bacterial meningitis presents with the classic triad of fever, nuchal rigidity, and a change in mental status.
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