chronic meningitis

Chronic Meningitis: A Long-Lasting Inflammation

Chronic meningitis is a condition characterized by a long-lasting inflammation of the membranes lining the brain and spinal cord (known as the meninges). By definition, the duration of signs, symptoms, and inflammation in chronic meningitis last longer than 4 weeks [1]. This prolonged inflammation can lead to various complications and symptoms.

Causes and Symptoms

Chronic meningitis can be caused by infectious organisms such as bacteria, fungi, and viruses. The symptoms of chronic meningitis are similar to those of new-onset meningitis but come on slower and last longer [2]. Common symptoms include:

• Headache
• Fever
• Vomiting
• Brain fog

In some cases, fungal meningitis can occur, which is a rare form of the condition [3].

Development and Duration

Chronic meningitis develops slowly over weeks or longer and may last for months to years [4]. In rare instances, it can cause only mild symptoms and resolve on its own.

Diagnostic Challenges

Diagnosing chronic meningitis can be challenging due to its slow progression. The cerebrospinal fluid (CSF) cell count is often elevated in this condition, but there are exceptions in individuals with severe immunosuppression or certain forms of neoplastic meningitis [5].

Common Presenting Symptoms

The most common presenting symptom of chronic meningitis is headache, followed by altered cognition, nausea or vomiting, or fever [6]. Symptoms may be delayed by as

Diagnosing Chronic Meningitis

Chronic meningitis, also known as subacute or recurrent meningitis, is a condition where the inflammation of the meninges (the protective membranes surrounding the brain and spinal cord) persists for more than a month. Diagnosing chronic meningitis can be challenging, but several tests can help confirm the diagnosis.

Imaging Tests

• Computed Tomography (CT): A CT scan may be used to rule out other conditions that could cause similar symptoms, such as tumors or abscesses.
• Magnetic Resonance Imaging (MRI): An MRI is often more sensitive than a CT scan and can provide detailed images of the brain and spinal cord.

Spinal Tap (Lumbar Puncture)

A spinal tap, also known as a lumbar puncture, is a procedure where a sample of cerebrospinal fluid (CSF) is collected from the lower back. This test can help diagnose chronic meningitis by detecting abnormal cells or bacteria in the CSF.

• Analysis of CSF: The CSF sample is analyzed for signs of infection, inflammation, or other abnormalities.
• Repeated lumbar punctures: In some cases, repeated spinal taps may be necessary to collect a sufficient amount of CSF for analysis.

Other Diagnostic Tests

• Blood tests: Blood tests can help identify the underlying cause of chronic meningitis, such as an infection or autoimmune disorder.
• Cultures: Cultures of blood and CSF samples can help detect bacteria or other microorganisms that may be causing the infection.

According to [4], doctors usually do imaging of the head, such as CT or MRI, followed by a spinal tap (lumbar puncture) to diagnose chronic meningitis. A healthcare professional can also use a physical examination, blood tests, and cultures to help confirm the diagnosis ([6][7]).

Treatment Options for Chronic Meningitis

Chronic meningitis, also known as subacute or recurrent mening