Aseptic meningitis typically presents with fever, headache, stiff neck. CSF findings include what pattern, and which viruses are responsible for >90% of cases?

• A. Normal glucose, elevated protein, lymphocytosis; Enteroviruses account for >90% of cases
• B. Low glucose, elevated protein, neutrophilic predominance; bacterial meningitis
• C. Elevated glucose, low protein; Herpes viruses
• D. Normal glucose, normal protein, lymphocytosis; Retroviruses

Answer: (A)

Aseptic (viral) meningitis typically shows a CSF pattern of normal glucose, elevated protein, and a lymphocytic predominance of white cells. This reflects inflammation driven by viral infection rather than bacterial metabolism; viruses do not consume CSF glucose the way bacteria do, so glucose stays normal, while the blood–CSF barrier becomes leakier, raising protein, and the immune response is primarily lymphocytes.

Enteroviruses (such as echoviruses and coxsackieviruses) are by far the most common causes, responsible for more than 90% of aseptic meningitis cases. Other viruses can cause it but are far less frequent.

So the best match is a CSF profile with normal glucose, elevated protein, lymphocytosis, and a cause predominantly by enteroviruses.