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Meningitis 

Meningitis
Chapter:
Meningitis
Author(s):

Tom Solomon

DOI:
10.1093/med/9780198569381.003.0969
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date: 21 November 2018

Meningitis is defined as inflammation of the brain meninges, characterized clinically by inflammatory cells in CSF. When there is concurrent parenchymal brain involvement the term meningoencephalitis is used, meningoencephalomyelitis implies that there is spinal cord involvement too.

Although increased cellularity in the CSF, or pleocytosis, is traditionally considered the hallmark of meningitis, some organisms, particularly fungi, can cause meningitis without a pleocytosis, especially in the immunocompromised. The advent of more sensitive methods of detecting viral nucleic acid in the CSF such as the polymerase chain reaction, have also shown that viral central nervous system infection can occur without an associated pleocytosis. When none of the common bacterial agents is easily identified the term aseptic meningitis is often used. The majority of such cases are caused by viruses; non-viral causes of an aseptic meningitis picture include certain bacteria which are not readily cultured, and do not grow in standard culture media, such as Borrelia burgdorferi. The clinical presentations of meningitis can be broadly divided into the acute, recurrent, and chronic. The development of meningitis depends on the infecting organism, and also whether there is any particular host susceptibility.

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