brain, spinal cord, and nerve disorders
Subacute and Chronic Meningitis
Causes of Subacute and Chronic Meningitis
Subacute or chronic meningitis is usually caused by an infection. Many microorganisms can cause subacute or chronic meningitis. Among the most important microorganisms are Bacteria that cause Tuberculosis (TB) ( Bacteria that cause Lyme Disease ( Overview of Fungal Infections , including The bacteria that cause tuberculosis cause a form of chronic meningitis called tuberculous meningitis. Tuberculous meningitis can develop rapidly or gradually. Meningitis may develop when people are first infected. Or the bacteria may remain in the body in an inactive state and become reactivated later and cause meningitis. The bacteria may be reactivated when people are treated with drugs that suppress the immune system (such as tumor necrosis factor inhibitors, includinginfliximab,adalimumab,golimumab, certolizumab, andetanercept). Up to 8% of children and some adults with Lyme disease develop meningitis. Meningitis due to Lyme disease may be acute or chronic. Usually, it begins more slowly than acute viral meningitis. The most common cause of chronic meningitis in the Western hemisphere is (which causes Cryptococcosis ) These fungi are more likely to cause meningitis in people who have a Overview of Immunodeficiency Disorders due to disorders such as Less commonly, chronic meningitis is caused by the following: Other bacteria (such as those that cause Syphilis ) (which causes Coccidioidomycosis ) (which causes Toxoplasmosis ), usually in people with HIV infection or AIDS Viruses, such as HIV and Overview of Enterovirus Infections None Chronic meningitis is common among people who have HIV infection. Meningitis can result from the HIV infection. But many other organisms (includingCryptococcus neoformans,Mycobacterium tuberculosis, and several fungi) can also cause chronic meningitis in people with HIV infection. Disorders that are not infections can also cause chronic meningitis. They include Sarcoidosis None Certain disorders that cause inflammation, such as Systemic Lupus Erythematosus (SLE) (lupus), Overview of Leukemia , Years ago, a few people developed chronic fungal meningitis after they were givenmethylprednisolone(a corticosteroid) as an injection into the space around the spinal cord (called an epidural injection) in the lower back (for example, to relieve sciatica). In all cases, the drug had not been prepared using sterile techniques. Symptoms include headache, confusion, nausea, and/or fever. Most people also have a stiff neck, but about one third do not. Symptoms may occur up to 6 months after the injection. If people have any of these symptoms during the weeks or months after having a corticosteroid injection in their back, they should call their doctor. Occasionally, chronic meningitis persists for months or even years, but no organisms are identified, and death does not result. This type of meningitis is called chronic idiopathic meningitis. Treatment with antifungal drugs or corticosteroids does not help. However, some people with chronic idiopathic meningitis eventually recover without treatment. 