PROBLEM SOLVING IN CLINICAL PRACTICE
Investigating chronic meningitis
University Hospital of Wales, Cardiff, UK
Correspondence to:
Correspondence to L Hartley, University Hospital of Wales, Cardiff, CF14 4XW, UK; lmhartley{at}gmail.com
Chronic meningitis is a syndrome characterised by persistent and progressive signs and symptoms of meningitis along with cerebrospinal fluid (CSF) pleocytosis and elevated protein that fail to improve over 4 weeks. A detailed and careful history and examination is required along with CSF parameters to guide a clinician towards the aetiology of the problem. Neuroimaging modalities have become a useful tool in the quest for a diagnosis in such cases.
An interesting case is described in real time illustrating the process of making a diagnosis in chronic meningitis with an insight into investigations and subsequent management.
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