Chronic Meningitis: inflammation of the brain membranes

Chronic Meningitis is an infection that causes inflammation of the brain in the meninges ( lining of the brain ) which lasts for 1 month or more .

Chronic meningitis usually affects people who have impaired immune systems due to AIDS , cancer , other serious diseases , anti- cancer drugs or long-term use of prednisone .

CAUSE
Some infectious organisms can attack the brain and grow in the brain , then gradually cause symptoms and damage .
The most common is the fungus Cryptococcus , cytomegalovirus , a virus that causes AIDS , and the bacteria that cause tuberculosis , syphilis and Lyme disease .

Some non - infectious diseases ( eg, sarcoidosis ) , and some cancers menigen can irritate and cause chronic meningitis .
Non - infectious causes of the most common is the spread of lymphoma and leukemia in the meninges .

Inflammation of the meninges can also be caused by drugs used to treat cancer , a drug to organ transplant and even by medication non-steroidal anti-inflammatory ( eg ibuprofen ) .


Causes of Chronic & Aseptic Meningitis

infectious Causes	Non-infectious causes of
Viral diseases: Mumps, Polio, Koriomeningitis lymphocytic, Herpes, Chickenpox, Encephalitis equina east and west, Encephalitis St.. Louis, infectious mononucleosis, AIDS, viral infections because of the eco, coksakie or cytomegalovirus	Diseases of the brain: brain tumors, stroke, multiple sclerosis, sarcoidosis, leukemia
The cause of post-infection (the virus that causes meningitis disease through immune reactions after primary disease subsided): Measles, German Measles, Chicken Pox	Poisoning: Lead poisoning
Bacterial infections: tuberculosis, syphilis, leptospirosis, Mikoplasmosis, Lymphogranuloma venereum, cat's claw disease, Brucellosis, Whipple's disease serebralis	The reaction to the materials injected into the spinal column: Anti-cancer (chemotherapy), antibotik, dyes (for x-rays)
Other infections: Riketsiosis, toxoplasmosis, cryptococcosis, Trikinosis, Koksidioidomikosis, Cysticercosis, Malaria, Amebiasis	Drugs: Trimethoprim-sulfamethoxazole, Azathioprine, Carbamazepine, Drugs non-steroidal anti-inflammatory (ibuprofen, naproxen)

SYMPTOMS
Symptoms resemble bacterial meningitis , but the disease develops more slowly , usually over several weeks .


Fever is not as powerful as arising in bacterial meningitis .


Frequent headaches , confusion , and even back pain and neurological disorders ( eg, weakness , tingling , numbness and paralysis of the face ) .


Diagnosis
Diagnosis based on symptoms .


To confirm the diagnosis , usually do a CT scan or MRI of the head , followed by a lumbar puncture and examination of cerebrospinal fluid .
The number of white blood cells in the cerebrospinal fluid is higher than normal , but usually lower than in bacterial meningitis , and contains a population of different white blood cells ( lymphocytes more ) .
Pemerisaan microscopic organisms can indicate the cause .


An additional examination can be performed to determine tuberculosis , syphilis or fungi and certain viruses .


TREATMENT
Chronic meningitis due to non - infectious causes (eg sarcoidosis ) , are usually treated with prednisone .


Treatment depends on the cause of chronic meningitis .
If the cause is fungal , anti- fungal drug that is given intravenously . The most often given is amphotericin B , flucytosine and fluconazole .
If the infection is very difficult to cure , then sometimes amphotericin B injected directly into the cerebrospinal fluid , either through repeated lumbar puncture or Ommaya .


Meningitis due to Cryptococcus diiobati with a combination of amphotericin B with flucytosine .


Recurrent herpes meningitis can be treated with acyclovir , whereas untreated meningitis due to cytomegalovirus with ganciclovir .
Most cases of meningitis due to the virus will get better by itself and does not require special treatment .