Populations that appear to be more susceptible to aseptic meningitis, particularly viral meningitis, include children and elderly persons who interact or live in group settings. Thus physicians should be alert to this possibility if players present with meningitis-like symptoms. Because of the ominous prognosis of bacterial meningitis, prompt and accurate diagnosis of meningitis in any form is necessary so that proper treatment can be initiated. Although several different pathogens, including Mycobacterium tuberculosis and various fungi, can cause aseptic meningitis, most cases are viral. The types of enteroviruses causing viral meningitis vary annually.
Most patients show some obvious signs and symptoms of meningitis.
A more specific diagnosis can be pursued after treatment has begun. A subacute onset of symptoms usually causes physicians to consider a nonbacterial etiology. All types of meningitis, however, may develop acutely or subacutely, with most cases developing subacutely. The remainder of this article focuses on the subacute presentation. Inquiry should also be made about recent contact with anyone who had an acute illness, especially meningitis.