Aseptic Meningitis.....can it wait?

[Hollymist]

I previously posted in Sep't. I am a 40 yo nurse with sarcoidosis, fibromyalgia, DJD, and a chronic headache problem undiagnosed since 5/00. Since 9/26,I have had a further worsening of headache and spine pain to a constant pressure, irritation, and severe worsening of symptoms on sitting or standing. I am basically on bedrest, and up for brief periods for adl's. Hr's are fast with attempted activities. I was adm. to a Columubs, OH hospital 10/2, and a spinal tap was done discovering an aseptic meningitis. The consensus is this has most likely been a chronic undiagnosed meningitis in exacerbation. Mri's of head and spine were negative for sarcoid enhancement, Cisternogram and all cultures were negative, ans spinal ace <4. I have no neuro defecits. On d/c they finally started me on po prednisone 60 mg x3days, 50mg x 3days, and then changed it to medrol, as the prednisone did not appear to be helping. I am currently tapering off at 20 mg/day, and feel it has helped my sx's by maybe 20%. I saw the neurologist and infectious ds. Dr. Mon.and they are deferring all further testing & tx. to a Cleveland CLinic neuro-immunologist, saying they are not sure if this is Sarcoidosis, and they have no further ideas. My app't is not until Dec. 7th, and I am miserable! I am in severe pain, and feel as if I have rapidly deteriorated over the past month. All they plan on doing is giving me high doses of narcotics to cope with the severe constant pain until I can be seen. I feel if this is an inflam. rocess, it should be treated now, and I wouldn't need the narcotics. Please Help! Thanks!

[CCF-Neuro-M.D.-JT]

Sorry to hear about your symptoms. As I'm sure you know, there's unfortunately no magic antibiotic we have for aseptic meningitis. Depending on its suspected cause (viral, inflamm, etc...) it's usually treated with fluids and bedrest as well as serial spinal taps. There is a special type of recurrent aseptic meningitis called Mollaret's meningitis which is a benign condition that is thought to be caused by the herpes virus. Potentially, it could be treated with acyclovir. However, it's not always found in patients with this problem.

The fast HR with "attempted activities" is likely orthostatic and due to dehydration. It may do you some good to get some IV fluids if you have had decreased oral intake. Finally, if you're in that much pain and feel you are getting worse, go back to the ER to get re-evaluated. Glad you are seeing a CCF neuro soon. Best of luck.