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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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.