Méningites chroniques : étiologies, diagnostic et thérapeutique

Colombe, B.; Derradji, M.; Bosseray, A.; Massot, Christian; Debru, J L

doi:10.1016/s0248-8663(02)00002-4

Cited by 9 publications

(1 citation statement)

References 54 publications

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“…Besides traveling, other significant exposures include unprotected sexual contact for syphilis or HIV, contact with animals such as rats for leptospirosis, or eating high-risk food such as unpasteurized milk for brucellosis or consumption of snails or raw fishes for angiostrongyliasis. 29 Brucellosis is sporadically described in Brazil, particularly in the Southern Region. 30 Different immunosuppression patterns may predispose to different causes of chronic meningitis 31 : cryptococcal meningitis is the most common cause of chronic meningitis in PLWH and may occur in solid-organ transplant recipients; patients with agammaglobulinemia and those receiving B-cell depleting immunotherapy have a risk of chronic enteroviral meningitis.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Diagnostic and therapeutic approach to chronic meningitis in Brazil: a narrative review

et al. 2022

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Background Chronic meningitis (CM) is characterized by neurological symptoms associated with the evidence of cerebrospinal fluid pleocytosis lasting > 4 weeks. Studies on the management of CM in Brazil are scarce. Objective To critically review the literature on CM and propose a rational approach in the Brazilian scenario. Methods Narrative literature review discussing the epidemiology, clinical evaluation, basic and advanced diagnostic testing, and empirical and targeted therapy for the most relevant causes of CM. The present review was contextualized with the local experience of the authors. In addition, we propose an algorithm for the management of CM in Brazil. Results In Brazil, tuberculosis and cryptococcosis are endemic and should always be considered in CM patients. In addition to these diseases, neurosyphilis and other endemic conditions should be included in the differential diagnosis, including neurocysticercosis, Baggio-Yoshinari syndrome, and endemic mycosis. After infectious etiologies, meningeal carcinomatosis and autoimmune diseases should be considered. Unbiased and targeted methods should be used based on availability and clinical and epidemiological data. Conclusion We propose a rational approach to CM in Brazil, considering the epidemiological scenario, systematizing the etiological investigation, and evaluating the timely use of empirical therapies.

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Section: Clinical Evaluationmentioning

confidence: 99%

Diagnostic and therapeutic approach to chronic meningitis in Brazil: a narrative review

et al. 2022

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Chronic meningitis

Helbok

Broessner²,

Pfausler³

et al. 2009

J Neurol

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Chronic meningitis is an inflammation of the meninges with subacute onset and persisting cerebrospinal fluid (CSF) abnormalities lasting for at least one month. Several non-infectious and infectious etiologies are known to be causative. The wide range of different etiologies renders the approach to patients with this syndrome particularly difficult. There is no standardized diagnostic procedure, thus, taking an in depth history combined with a complete physical examination is mandatory in every patient.This review aims to present the current knowledge on etiology, neurological course of disease, diagnostic and therapeutic management steps of patients presenting with clinical signs and symptoms of chronic meningitis and meningoencephalitis. Still, the etiology of one third of patients remains unclear, reflecting the diagnostic challenge of this syndrome for each physician or neurologist, respectively. However, most patients with idiopathic chronic meningitis have a relatively good outcome.

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