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Chronic Meningitis

more about Chronic Meningitis

  • Meningitis is an infection of the fluid and tissue in the spinal column. Chronic Meningitis refers to any of a number of types of slowly progressing infections of the fluid and tissue of the spinal column. Symptoms usually occur over weeks or months, as opposed to acute Meningitis, in which symptoms progress very rapidly. To follow below is a discussion of the most common causes. Your physician will need to determine the actual diagnosis and treatment course.

  • Fever
  • Headache
  • Neck stiffness
  • Confusion
  • Behavioral changes

  • Tuberculosis
  • Atypical tuberculi
  • Cryptococcus
  • Coccidiodes
  • Histoplasma
  • Syphilis
  • Lyme disease

  • Lumbar puncture (spinal tap) may show:
    1. Elevated white blood cell count (neutrophils elevated early, lymphocytes elevated later), low glucose, elevated protein, and Tuberculosis and atypical tuberculi by using acid fast stain and special culture techniques
    2. India ink stain, cryptococcal antigen, and cultures help to identify cryptococcocus as the cause.
    3. Increased white blood cell count, decreased glucose, antibodies to coccidiodes, and fungal cultures can identify cocciodes as the cause.
    4. Spinal fluid shows increased white blood cell count and elevated protein levels. A positive blood test for Syphilis points to Syphilis as the cause of Meningitis.
    5. Elevated white blood cell count and proteins. If the antibody ratio in spinal fluid to antibody in blood is greater than 1.0 as in Lyme Disease, it is suspected as the cause of Meningitis.

  • HIV Infection
  • Hodgkin's disease
  • Chronic use of corticosteroids (e.g., Prednisone)

  • Tuberculosis -- a typical regimen may include Isoniazid, Rifampin, and Pyrazinamide
  • Atypical tuberculi -- determined by infectious disease specialist
  • Coccidiodes -- intravenous Amphotericin B then oral Fluconazole
  • Histoplasma -- intravenous Amphotericin B, possible followed by oral Itraconazole
  • Cryptococcocus -- Oral Fluconazole or Amphotericin B intravenously/-Flucytosine
  • Syphilis -- Penicillin intravenously
  • Choramphenicol, Doxycycline, and Ceftriaxone are alternatives for those with penicillin allergy.
  • Lyme Disease -- Ceftriaxone intravenously

  • Seek immediate medical attention as this condition can lead to permanent disability and death. The explanation here is only a rough outline of diagnosis and treatment. The diagnosis often takes expert physician analysis, often involving the services of an Infectious disease specialist.

more about Chronic Meningitis

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