Physicians must generally be relieved—and occasionally elated—to find a normal spinal-fluid sugar content and normal Gram stain in a patient who has symptoms of meningitis. Further studies in such a patient may show a high percentage of mononuclear cells in the spinal fluid with negative cultures for bacteria. When this is the case, the illness is often attributed to a coxsackievirus or echovirus infection. The patient is reassured and the details of his recovery become unimpressive amid the subsequent daily activities of the physician.
A study in the April issue of the Archives of Neurology' shows that echoviruses were the most common organisms found in 45 patients admitted to a North Carolina hospital because of ominous meningeal signs. All had positive viral cultures, titer increases, or both. Of the 26 patients who subsequently proved to have echovirus meningoencephalitis, 18 were infected with echovirus 4. It is difficult to differentiate the
VIRAL MENINGITIS. JAMA. 1965;192(4):322. doi:10.1001/jama.1965.03080170050015
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