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Investigating chronic meningitis
  1. N Syed,
  2. A Saxena,
  3. L Hartley
  1. University Hospital of Wales, Cardiff, UK
  1. Correspondence to L Hartley, University Hospital of Wales, Cardiff, CF14 4XW, UK; lmhartley{at}


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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  • Funding None.

  • Competing interests None.

  • Provenance and Peer review Commissioned; externally peer reviewed.

  • Patient consent This is a real case scenario and patient and parental consent was obtained.