Chronic meningitis - Revision history

Aidan: Text replacement - " species]]" to "]]"

2022-02-05T08:00:36Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 08:00, 5 February 2022
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	\|[[Borrelia burgdorferi]]		\|[[Borrelia burgdorferi]]
	\|exposure to [[Ixodes ~~species~~]] ticks		\|exposure to [[Ixodes]] ticks
	\|preceding erythema migrans		\|preceding erythema migrans
	\|serology		\|serology

Aidan at 21:41, 12 August 2020

2020-08-12T21:41:53Z

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Aidan at 00:26, 8 June 2020

2020-06-08T00:26:28Z

← Older revision		Revision as of 00:26, 8 June 2020
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	** ''[[Angiostrongylus cantonensis]]''		** ''[[Angiostrongylus cantonensis]]''
	* '''Other causes'''		* '''Other causes'''
	** Post-~~surgical~~ causes: infected CSF shunt, infected prosthetic material		** Post-neurosurgical causes: infected CSF shunt, infected prosthetic material
	** Tumours: diffuse ~~giomatosis~~, metastatic meningeal malignancies including lymphomatous meningitis		** Tumours: diffuse gliomatosis, metastatic meningeal malignancies including lymphomatous meningitis
	** Others: sarcoidosis, Vogt-Koyanagi-Harada syndrome, Behçet syndrome, IgG4-related hypertrophic pachymeningitis		** Others: sarcoidosis, Vogt-Koyanagi-Harada syndrome, Behçet syndrome, IgG4-related hypertrophic pachymeningitis

Aidan: Initial creation with DDx and Investigations

2020-06-07T17:23:15Z

Initial creation with DDx and Investigations

New page

==Background==

==Differential Diagnosis==

* '''Fungal infections'''
** ''[[Cryptococcus]]''
** ''[[Coccidioides]]''
** ''[[Histoplasma]]''
** ''[[Candida]]''
** ''[[Sporothrix]]'' (rare)
** ''[[Blastomyces]]'' (rare)
** Other rare molds: ''[[Scedosporium]]'', ''[[Aspergillus]]'', ''[[Cladophialophora]]'', and other [[dematiaceous molds]]
* '''Bacterial infections'''
** ''[[Mycobacterium tuberculosis]]''
** ''[[Treponema pallidum]]''
** ''[[Borrelia burgdorferi]]''
** ''[[Tropheryma whipplei]]''
** ''[[Actinomyces]]'' (parameningeal, rare)
** ''[[Nocardia]]'' (with brain abscess)
** ''[[Brucella]]'' (rare)
* '''Viral infections'''
** [[Echovirus]] (meningoencephalitis)
* '''Parasitic infections'''
** ''[[Acanthamoeba]]''
** ''[[Balamuthia]]''
** ''[[Taenia solium]]''
** ''[[Angiostrongylus cantonensis]]''
* '''Other causes'''
** Post-surgical causes: infected CSF shunt, infected prosthetic material
** Tumours: diffuse giomatosis, metastatic meningeal malignancies including lymphomatous meningitis
** Others: sarcoidosis, Vogt-Koyanagi-Harada syndrome, Behçet syndrome, IgG4-related hypertrophic pachymeningitis

==Investigations==
* CSF tests:
** Glucose, protein, cell count and differential (including eosinophils)
** India ink on centrifuged sediment
** Fungal culture of 3-5 mL of CSF
** Cytopathology for malignant cells, including PCR or flow cytometry for monoclonal B cells
** Periodic acid-Schiff stain for Whipple disease
** VDRL test
** Cryptococcal antigen
** ''[[Histoplasma]]'' antigen
** ''[[Aspergillus]]'' galactomannan antigen
** ''[[Coccidioides]]'' antibody by complement fixation or immunodiffusion
** PCR for [[tuberculosis]], [[Whipple disease]], [[enterovirus]], and lymphoma
** Culture for [[enterovirus]] and ''[[Acanthamoeba]]''
* Blood tests
** RPR or other routine [[syphilis]] screening
** Serology for ''[[Coccidioides]]'', ''[[Histoplasma]]'', ''[[Toxoplasma]]'', and ''[[Brucella]]'' antibodies
** Serology for ''[[Histoplasma]]'' antigen (may be from blood or urine)
* Brain biopsy has low diagnostic yield in chronic meningitis

[[Category:CNS infections]]