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Published on: November 5, 2019
Chronic Meningitis
1MCP Hahnemann University, 3300 Henry Avenue, Philadelphia, PA 19129, USA.
Abstract:
Chronic meningitis may be caused by a large number of infectious agents, including spirochetes (Treponema pallidum, Borrelia burgdorferi), Mycobacterium tuberculosis, and fungi (primarily Cryptococcus neoformans). The incidence of these specific causes of chronic meningitis has been impacted since the advent of HIV infection, and new information is also available on how this epidemic has affected populations in developing countries of the world. In the area of diagnostics, the development of polymerase chain reaction has been a major advance that has increased our capabilities for identifying etiologic agents (such as M. tuberculosis) that are difficult to culture. Finally, the management of patients with chronic meningitis has evolved, and the availability of new antifungal agents and adjunctive strategies has changed the approach to the patient with cryptococcal meningitis.
Insights
Chronic meningitis can stem from various infections like spirochetes, Mycobacterium tuberculosis, and fungi. Advances in diagnostics and treatments, particularly for cryptococcal meningitis, have improved patient outcomes.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Chronic meningitis presents diverse etiologies including spirochetes, Mycobacterium tuberculosis, and fungi.
- HIV infection has significantly impacted the incidence and epidemiology of chronic meningitis globally.
- Developing countries face unique challenges in managing chronic meningitis due to the HIV epidemic.
Purpose of the Study:
- To review the spectrum of infectious causes of chronic meningitis.
- To discuss the impact of HIV on meningitis epidemiology.
- To highlight advancements in diagnostic and therapeutic strategies for chronic meningitis.
Main Methods:
- Literature review of infectious causes of chronic meningitis.
- Analysis of the epidemiological impact of HIV on meningitis.
- Overview of diagnostic innovations, including polymerase chain reaction (PCR).
- Review of evolving management strategies for fungal meningitis.
Main Results:
- Polymerase chain reaction (PCR) has enhanced the identification of challenging etiologic agents like M. tuberculosis.
- New antifungal agents and adjunctive therapies have transformed the management of cryptococcal meningitis.
- Understanding the influence of HIV is crucial for global meningitis control.
Conclusions:
- Effective management of chronic meningitis requires accurate diagnosis and tailored treatment strategies.
- Continued research into novel diagnostics and therapeutics is essential.
- Public health initiatives addressing HIV are critical for reducing meningitis burden worldwide.
Related Concept Videos
Bacterial Meningitis
Viral Meningitis
Cryptococcal Meningitis
Bacterial Meningitis I: Introduction
Bacterial Meningitis II: Pathophysiology
Brain Abscess l: Introduction

