Systemic inflammatory disorders in patients admitted for aseptic meningitis

Area of Science:

• Neurology
• Rheumatology
• Internal Medicine

Background:

• Acute meningitis can be the initial presentation of underlying systemic inflammatory disorders (SIDs).
• Early identification of SIDs in meningitis patients is essential for timely and appropriate management.

Purpose of the Study:

• To identify clinical indicators for systemic inflammatory disorders (SIDs) in patients presenting with acute aseptic meningitis.
• To improve the diagnostic yield of SIDs in patients hospitalized for acute aseptic meningitis.

Main Methods:

• Retrospective analysis of patients hospitalized for acute aseptic meningitis over a 4-year period.
• Exclusion of patients with neoplastic meningitis.
• Systematic recording of extraneurological signs and application of international criteria for SID diagnosis.

Main Results:

• Out of 43 analyzed patients, 23 (53.5%) had an underlying SID, predominantly sarcoidosis and Behçet's disease.
• Logistic regression revealed a 93.7% probability of SID in patients with both neurological and extraneurological signs.
• Conversely, patients with neither neurological nor extraneurological signs had only a 14.9% probability of SID.

Conclusions:

• Clinical assessment incorporating both neurological and extraneurological signs is valuable for identifying patients with acute aseptic meningitis caused by SIDs.
• This approach aids in the early detection and management of systemic inflammatory disorders presenting as meningitis.