Chronic lymphocytic meningitis or (meningo-) encephalitis | Non-purulent meningitis

Chronic lymphocytic meningitis or (meningo-) encephalitis

The pathogens of this form of meningitis are usually not viruses, but apart from Lyme disease, they frequently occur in poor countries, in HIV-infected persons and other patients with weakened immune system and show themselves with a slow reduction of personality, disturbances of attention and memory and increasing neurological deficits. The cell count in the cerebrospinal fluid (liquor) is not or only slightly increased. At the time of diagnosis, in contrast to acute (fresh) processes, antibody production within the cerebrospinal fluid can often be detected (intrathecal immunoglobulin synthesis).

The antibodies against a virus are then more highly concentrated in the cerebrospinal fluid than in the blood, which indicates that a slowly growing process is taking place within the central nervous system (CNS).

  • Fungi (e.g. cryptococcus, cryptococcal meningitis/encephalitis),
  • Parasites (e.g. toxoplasmas, toxoplasmosis, pathogens are transmitted by cats)
  • The tuberculosis pathogen (Mycobacterium tuberculosis, tuberculous meningitis) and other mycobacteria
  • Bacteria like the Borrelia (Borrelia burgdorferi, Lyme disease, pathogens are transmitted by ticks) or the pathogens of syphilis, Treponema pallidum (Neurolues, Neurosyphilis)
  • And others.

Summary

The pathogen-related, non-purulent inflammatory processes in the central nervous system (meningitis, encephalitis, meningoencephalitis) can be classified as follows: An inflammatory process caused by viruses should always be considered if the following factors can be found in the patient’s medical history (anamnesis)

  • Viral diseases in the environment (e.g. mumps, chickenpox, polio)
  • Insect or tick bites (e.g. FSME virus, borrelia (borreliosis)
  • Animal bites (e.g.

    rabies)

  • After blood transfusions or organ transplants (e.g. HIV, hepatitis A, hepatitis B, hepatitis C virus, cytomegalovirus (CMV), parvo-virus B19 (causative agent of rubella)
  • Immunodeficiency due to cancer, drugs (e.g. rheumatism or rheumatoid arthritis) or AIDS (e.g. CMV, Varicella-Zoster-Virus (VZV))
  • Stays abroad
  • Viral (acute lymphocytic, serous) meningitis
  • Non-viral (chronic lymphocytic) meningitis
  • Acute viral encephalitis