ICD-10: A87.0

Enteroviral meningitis, classified under ICD-10 code A87.0, is a viral infection that affects the meninges, the protective membranes covering the brain and spinal cord. The diagnosis of enteroviral meningitis involves several criteria and considerations, which can be categorized into clinical, laboratory, and epidemiological aspects.

Clinical Criteria

1. Symptoms: Patients typically present with symptoms such as:
   - Fever
   - Headache
   - Stiff neck
   - Photophobia (sensitivity to light)
   - Nausea and vomiting
   - Altered mental status (in severe cases)

2. Physical Examination: Neurological examination may reveal signs of meningeal irritation, such as:
   - Kernig's sign (inability to straighten the leg when the hip is flexed)
   - Brudzinski's sign (involuntary lifting of the legs when the neck is flexed)

Laboratory Criteria

1. Cerebrospinal Fluid (CSF) Analysis: A lumbar puncture is performed to obtain CSF, which is analyzed for:
   - Cell Count: Typically shows a lymphocytic pleocytosis (increased white blood cells, predominantly lymphocytes).
   - Protein Levels: Often elevated in viral meningitis.
   - Glucose Levels: Usually normal, distinguishing it from bacterial meningitis where glucose is often low.

2. Viral Testing: Specific tests to identify enteroviruses include:
   - PCR (Polymerase Chain Reaction): Highly sensitive and specific for detecting enteroviral RNA in CSF.
   - Viral Culture: Less commonly used due to longer turnaround times but can confirm the presence of the virus.

3. Serological Tests: These may be performed to detect antibodies against enteroviruses, although they are not the primary diagnostic tool.

Epidemiological Criteria

1. Seasonality: Enteroviral infections are more common in late summer and early fall, which can help in the diagnosis during these periods.

2. Outbreaks: Awareness of local outbreaks of enteroviral infections can support the diagnosis, especially in pediatric populations.

3. Exposure History: Recent exposure to individuals with viral infections or participation in activities that increase the risk of enteroviral transmission (e.g., swimming in contaminated water) may be relevant.

Conclusion

The diagnosis of enteroviral meningitis (ICD-10 code A87.0) is based on a combination of clinical symptoms, laboratory findings from CSF analysis, and epidemiological context. Accurate diagnosis is crucial for appropriate management and to differentiate it from other types of meningitis, particularly bacterial meningitis, which requires different treatment approaches. If you have further questions or need more specific information, feel free to ask!

Enteroviral meningitis, classified under ICD-10 code A87.0, is a viral infection characterized by inflammation of the protective membranes covering the brain and spinal cord, primarily caused by enteroviruses. This condition is particularly significant in pediatric populations but can affect individuals of all ages.

Clinical Description

Etiology

Enteroviral meningitis is primarily caused by enteroviruses, which are a group of viruses that include coxsackieviruses, echoviruses, and enterovirus D68, among others. These viruses are commonly found in the gastrointestinal tract and can be transmitted through fecal-oral routes, respiratory droplets, or direct contact with contaminated surfaces[1][2].

Symptoms

The clinical presentation of enteroviral meningitis can vary but typically includes:

• Fever: Often the first symptom, indicating an infectious process.
• Headache: A common complaint, which may be severe.
• Stiff Neck: Indicative of meningeal irritation, often assessed through physical examination.
• Photophobia: Sensitivity to light, which can accompany headaches.
• Nausea and Vomiting: These gastrointestinal symptoms may also be present.
• Altered Mental Status: In some cases, patients may exhibit confusion or lethargy.

In infants, symptoms may be less specific and can include irritability, poor feeding, and a bulging fontanelle[3][4].

Diagnosis

Diagnosis of enteroviral meningitis typically involves:

• Clinical Evaluation: Assessment of symptoms and medical history.
• Lumbar Puncture: Analysis of cerebrospinal fluid (CSF) is crucial. In enteroviral meningitis, CSF typically shows an elevated white blood cell count with a predominance of lymphocytes, normal glucose levels, and elevated protein levels.
• Viral Testing: PCR (polymerase chain reaction) testing of CSF can confirm the presence of enteroviruses, which is a definitive diagnostic tool[5][6].

Treatment

There is no specific antiviral treatment for enteroviral meningitis. Management is primarily supportive and may include:

• Hydration: Ensuring adequate fluid intake.
• Pain Management: Use of analgesics for headache relief.
• Monitoring: Close observation for any complications, especially in severe cases.

Most patients recover fully without long-term complications, although some may experience lingering symptoms such as fatigue or headaches[7][8].

Conclusion

Enteroviral meningitis, coded as A87.0 in the ICD-10 classification, is a viral infection that requires prompt diagnosis and supportive care. Understanding its clinical presentation, diagnostic criteria, and management strategies is essential for healthcare providers to ensure effective treatment and minimize complications. If you suspect a case of enteroviral meningitis, timely intervention and monitoring are critical for patient outcomes.

References

1. Meningitis, Viral | 5-Minute Clinical Consult.
2. ICD-10 Version:2019.
3. Meningitis gone viral: description of the echovirus wave.
4. Infectious Disease ICD-10 Codes.
5. SO2- D2.5.2.1 - AESI Case Definition Companion Guide for.
6. Article - Billing and Coding: MolDX: Molecular Syndromic.
7. Clinical guidelines on viral meningitis.
8. Overview of enteroviral infections and their implications.

Enteroviral meningitis, classified under ICD-10 code A87.0, is a viral infection of the central nervous system (CNS) primarily caused by enteroviruses. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Enteroviral meningitis typically presents with a range of symptoms that can vary in severity. The onset is often abrupt, and the clinical features may include:

• Fever: A common initial symptom, often accompanied by chills.
• Headache: Patients frequently report a severe headache, which can be persistent and debilitating.
• Neck Stiffness: This is a classic sign of meningitis, indicating irritation of the meninges.
• Photophobia: Sensitivity to light is often reported, contributing to discomfort.
• Nausea and Vomiting: Gastrointestinal symptoms may accompany the neurological signs.
• Altered Mental Status: In some cases, patients may experience confusion or lethargy.

Signs and Symptoms

The signs and symptoms of enteroviral meningitis can be categorized into neurological and systemic manifestations:

Neurological Signs

• Meningeal Signs: Positive Brudzinski's sign (involuntary lifting of the legs when the neck is flexed) and Kernig's sign (inability to straighten the leg when the hip is flexed) are indicative of meningeal irritation.
• Cranial Nerve Palsies: Rarely, enteroviral infections can lead to cranial nerve dysfunction.
• Seizures: Some patients may experience seizures, particularly in severe cases.

Systemic Symptoms

• Fever: Often high-grade, indicating an infectious process.
• Fatigue and Malaise: Generalized weakness and a feeling of unwellness are common.
• Rash: In some cases, a rash may be present, particularly if the enteroviral infection is associated with other viral syndromes.

Patient Characteristics

Enteroviral meningitis can affect individuals of all ages, but certain characteristics are more prevalent in specific demographics:

• Age: It is most common in children, particularly those under five years old, due to their developing immune systems. However, adolescents and adults can also be affected.
• Seasonality: Enteroviral infections often peak in the summer and fall months, correlating with increased viral circulation.
• Immunocompromised Status: Patients with weakened immune systems, such as those with chronic illnesses or undergoing immunosuppressive therapy, are at higher risk for severe manifestations.
• Geographic Factors: Outbreaks may occur in specific regions, influenced by local epidemiology and public health factors.

Conclusion

Enteroviral meningitis, denoted by ICD-10 code A87.0, presents with a distinct set of clinical features, including fever, headache, and neck stiffness, among others. Understanding the signs, symptoms, and patient characteristics associated with this condition is essential for timely diagnosis and management. Given its prevalence in children and seasonal patterns, healthcare providers should maintain a high index of suspicion during peak seasons, especially in pediatric populations. Early recognition and supportive care are key to improving patient outcomes in cases of enteroviral meningitis.

Enteroviral meningitis, classified under ICD-10 code A87.0, is a viral infection of the meninges caused primarily by enteroviruses. Understanding the alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some of the key alternative names and related terms associated with A87.0.

Alternative Names for Enteroviral Meningitis

1. Viral Meningitis: While A87.0 specifically refers to enteroviral meningitis, it is often categorized under the broader term "viral meningitis," which encompasses meningitis caused by various viruses, including enteroviruses, herpesviruses, and others[4].

2. Aseptic Meningitis: This term is frequently used interchangeably with viral meningitis. It refers to meningitis that is not caused by bacteria, and enteroviral meningitis falls under this category[5].

3. Coxsackievirus Meningitis: Since coxsackieviruses are a common cause of enteroviral meningitis, this term may be used to specify the viral agent involved in some cases[7].

4. Echovirus Meningitis: Similar to coxsackieviruses, echoviruses are another group of enteroviruses that can lead to meningitis, and this term may be used in specific contexts[7].

5. Non-bacterial Meningitis: This term emphasizes the absence of bacterial infection in the meningitis diagnosis, which is relevant for enteroviral cases[6].

Related Terms

1. Enterovirus Infections: This broader term encompasses all infections caused by enteroviruses, including those affecting the central nervous system (CNS) and leading to meningitis[7].

2. Meningitis: A general term for inflammation of the protective membranes covering the brain and spinal cord, which can be caused by various infectious agents, including viruses, bacteria, and fungi[6].

3. Central Nervous System (CNS) Infections: This term includes all infections that affect the CNS, which can be viral, bacterial, or fungal in nature, and encompasses enteroviral meningitis as a specific type[7].

4. Viral Encephalitis: While distinct from meningitis, this term refers to inflammation of the brain caused by viral infections, which can sometimes occur alongside meningitis[6].

5. Meningoencephalitis: This term describes a condition where both the meninges and the brain are inflamed, which can occur in severe cases of viral infections, including those caused by enteroviruses[6].

Conclusion

Understanding the alternative names and related terms for ICD-10 code A87.0: Enteroviral meningitis is crucial for accurate diagnosis, treatment, and communication within the healthcare community. These terms not only facilitate clearer documentation but also enhance the understanding of the condition's scope and implications. If you have further questions or need additional information on this topic, feel free to ask!

Enteroviral meningitis, classified under ICD-10 code A87.0, is a viral infection of the central nervous system primarily caused by enteroviruses, such as echoviruses and coxsackieviruses. This condition is characterized by inflammation of the protective membranes covering the brain and spinal cord, leading to symptoms such as fever, headache, neck stiffness, and altered mental status. Understanding the standard treatment approaches for enteroviral meningitis is crucial for effective management and patient care.

Diagnosis and Initial Assessment

Before treatment can begin, a thorough diagnosis is essential. This typically involves:

• Clinical Evaluation: Assessing symptoms and medical history.
• Lumbar Puncture: A spinal tap is performed to analyze cerebrospinal fluid (CSF), which can reveal elevated white blood cell counts, elevated protein levels, and normal glucose levels, indicative of viral meningitis[1].
• Viral Testing: PCR (polymerase chain reaction) testing of the CSF can confirm the presence of enteroviruses[2].

Standard Treatment Approaches

Supportive Care

The primary treatment for enteroviral meningitis is supportive care, as there is no specific antiviral therapy for enteroviruses. Supportive measures include:

• Hydration: Ensuring adequate fluid intake to prevent dehydration, especially if the patient has fever or is unable to eat or drink.
• Pain Management: Administering analgesics such as acetaminophen or ibuprofen to alleviate headache and fever[3].
• Monitoring: Close observation of neurological status and vital signs to detect any deterioration in the patient's condition.

Hospitalization

In some cases, particularly for severe symptoms or in vulnerable populations (e.g., infants, immunocompromised individuals), hospitalization may be necessary. This allows for:

• Intravenous Fluids: To maintain hydration and electrolyte balance.
• Neurological Monitoring: Continuous assessment for any signs of complications, such as seizures or increased intracranial pressure[4].

Antiviral Therapy

While there is no specific antiviral treatment for enteroviral meningitis, research is ongoing into potential therapies. Currently, the use of antiviral medications is not standard practice for this condition, as enteroviral infections typically resolve on their own within 7 to 10 days[5].

Prevention

Preventive measures are crucial in managing enteroviral meningitis outbreaks. These include:

• Hygiene Practices: Encouraging frequent handwashing and proper sanitation to reduce the spread of enteroviruses.
• Vaccination: While there is no specific vaccine for enteroviruses, vaccines for other viral infections (like polio) can help reduce the incidence of related complications[6].

Conclusion

In summary, the management of enteroviral meningitis (ICD-10 code A87.0) primarily revolves around supportive care, as there is no specific antiviral treatment available. Early diagnosis and appropriate supportive measures are essential for recovery. Continuous research into antiviral therapies and preventive strategies remains important to improve outcomes for patients affected by this viral infection. If you suspect enteroviral meningitis, it is crucial to seek medical attention promptly for appropriate evaluation and management.