Signs and symptoms
Viral meningitis characteristically presents with fever, headache and neck stiffness. Fever is the result of cytokines released that affect the thermoregulatory (temperature control) neurons of the hypothalamus. Cytokines and increased intracranial pressure stimulate nociceptors in the brain that lead to headaches. Neck stiffness is the result of inflamed meninges stretching due to flexion of the spine. The various layers of meninges act form a separation between the brain and the skull. In contrast to bacterial meningitis, symptoms associated with viral meningitis are often less severe and do not progress as quickly. Nausea, vomiting and photophobia (light sensitivity) also commonly occur, as do general signs of a viral infection, such as muscle aches and malaise. Increased cranial pressure from viral meningitis stimulates the area postrema, which causes nausea and vomiting. Widened pulse pressure (systolic - diastolic blood pressure), bradycardia, and irregular respiration would be alarming for Cushings reflex, a sign of acutely elevated intracranial pressure. Photophobia is due to meningeal irritation. In severe cases, people may experience concomitant encephalitis (meningoencephalitis), which is suggested by symptoms such as altered mental status, seizures or focal neurologic deficits.Babies with viral meningitis may only appear irritable, sleepy or have trouble eating. Infection in the neonatal period may be the result of infection during pregnancy. In severe cases, people may experience concomitant encephalitis (meningoencephalitis), which is suggested by symptoms such as altered mental status, seizures or focal neurologic deficits. The pediatric population may show some additional signs and symptoms that include jaundice and bulging fontanelles.
Coarse facial features or coarse facies describes a constellation of facial features that are present in many inborn errors of metabolism. Features include:
large, bulging head
prominent scalp veins
"saddle-like, flat bridged nose with broad, fleshy tip"
large lips and tongue
small, widely spaced and/or malformed teeth
hypertrophic alveolar ridges and/or gumsHeads tend to be longer than normal from front to back, with a bulging forehead. This is because of the earlier than normal or premature fusion of skull bones in an affected individual. Causes
Several conditions are associated with coarse facial features. Acromegaly
Alpha-mannosidosis type II
Aspartylglycosaminuria
Battaglia Neri syndrome
Borjeson Syndrome
Chromosome 6q deletion syndrome
Coarse face - hypotonia - constipation
Congenital hypothyroidism
Dandy-Walker malformation (with mental retardation basal ganglia disease and seizures)
Dyggve-Melchior-Clausen Syndrome
Fucosidosis type 1
Fucosidosis type II
Gangliosidosis generalized GM1 (type 1)
Gangliosidosis GM1 (type 3)
GM1 gangliosidosis
Goldberg syndrome
Hyde-Forster-Mccarthy-Berry syndrome
Hyper IgE
Hypomelanosis of Ito
I cell disease
Immunodeficiency due to defect in MAPBP-interacting protein
Infantile sialic acid storage disorder
Job syndrome
Mannosidosis (alpha B lysosomal)
McCune-Albright Syndrome
Mental retardation (X-linked - epilepsy - progressive joint contractures - typical face)
Mental retardation (X-linked Raynaud type)
Mieschers syndrome
Morquio syndrome
Morquio syndrome type A
Morquio syndrome type B
MPS 3 C
MPS 3 D
Mucolipidosis III
Mucopolysaccharidosis type 2 Hunter syndrome- mild form
Mucopolysaccharidosis type 2 Hunter syndrome- severe form
Mucopolysaccharidosis type 3
Mucopolysaccharidosis type 6
Mucopolysaccharidosis type 7 Sly syndrome
Mucopolysaccharidosis type I Hurler syndrome
Mucopolysaccharidosis type I Hurler/Scheie syndrome
Mucopolysaccharidosis type I Scheie syndrome
Multiple endocrine abnormalities - adenylyl cyclase dysfunction
Multiple endocrine neoplasia type 2b
Neuraminidase deficiency (type II juvenile form)
Nodulosis-arthropathy-osteolysis syndrome
Nonkeratan-sulfate-excreting Morquio syndrome
Pituitary tumors (adult)
Sialidosis type II (congenital)
Sialidosis type II (infantile)
Sialuria syndrome
Simpson-Golabi-Behmel syndrome
Simpson-Golabi-Behmel syndrome - type 1 (SGBS1)
Skeletal dysplasia - coarse facies - mental retardation
Spondyloepimetaphyseal dysplasia (genevieve type)
Sulfatidosis juvenile (Austin type)
Winchester syndrome

See also
Facies (medical)

References
External links
https://web.archive.org/web/20090106211640/http://www.mps1disease.com/patient/about/mps_pt_symptom_coarse_facial_features.asp