The importance of the virology laboratory in the diagnosis and management of viral meningitis.

Recent advances in cell culture techniques have made possible the rapid and accurate detection of enteroviruses, the most commonly identified cause of aseptic meningitis. Between 1983 and 1985, 69 patients were diagnosed as having enteroviral meningitis by viral culture of cerebrospinal fluid, throat swab, and/or rectal swab or stool specimens. Half of the 49 patients in whom the diagnosis was based on positive cerebrospinal fluid culture benefited directly from viral culture results by early withdrawal of antibiotics, early discharge, or changing of the diagnosis and prognosis of the disease. Enteroviral cultures became positive in as early as 24 hours, and most of the cultures became positive within one week. The cost of viral culture is comparable with that of other microbiologic tests. The virology laboratory has proved useful in the diagnosis and management of patients with enteroviral meningitis.