Most meningitis in adults is of viral aetiology. Most common viruses include enteroviruses and herpes viruses (HSV-2, VZV).

HSV-2 may be seen as part of the spectrum of primary (genital) infection. Consider a sexual history and STI testing where appropriate.

There are currently no antiviral treatments of proven benefit for most causes of viral meningitis.  It may be helpful to discuss cases with virology/infection specialist.

If antibiotics have been commenced they should be reviewed if a viral diagnosis is made.