Micro Organisms

Viral meningitis (including HSV and VZV) is commonly a self-limiting illness.

Antiviral treatment should be used where there are clinical features of encephalitis or in systemically unwell immunocompromised patient (i.e. possible viraemia)

Consider covering for bacterial meningo-encephalitis too where there are other clinical features that could suggest bacterial infection e.g. haemodynamically unstable, high peripheral blood WCC and/or CRP

First Line

Important: Therapy

Aciclovir 10mg/kg IV 8 hourly 

Notes:

IV route necessary to ensure adequate tissue levels

Adjust dose in renal impairment

Use ideal body weight in obesity