Re: chronic meningitis?

Posted By Lin on March 17, 1998 at 21:08:34:

In Reply to: Re: chronic meningitis? posted by CCF Neurology MD(B) on March 13, 1998 at 11:47:25:








Could you please tell me if one could have a chronic, undiagnosed meningitis? If so, what would the symtoms (symptoms) be? Also, Can a complication of osteomyelitis be meningitis? Thank you in advance.
=Dear Lin, Patients with chronic persistent meningitis of obscure etiology always pose a diagnostic problem.  Such patients have fever, stiff neck, headache and minor focal neurological signs that are not diagnostic.  The CSF will show a predominately mononuclear(lymphocytic) pleocytosis(increased) plus a raised(mild) CSF pressure.  A viral or some other type of infective inflamation (inflammation) is always suspected, but a search by culture methods and serology yields negative results.  Sometimes the process resolves over a period of months or a year or more.  In other cases, the cause is eventually found.  Concerning osteomyelitis, this is caused by an infectious process involving the bone and bone marrow.  The agent is invariably a very aggressive bacteria.  While bacteria is one of the leading causes of meningitis, the symptons are much more severe and if not treated immmediately, severe neurological complications can arise resulting in permanent damage to the CNS and quite possibly death.  Therefore, it would be sxtremely unlikely that osteomyelitis could give rise to chronic meningitis.  Hope this helps.  "This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition."
Thanks so much for responding. My problems began when I had discitis, 7 yrs. ago.It went undiagnosed which by the time it was, it had progressed to osteomyelitis involving the vertebra above and below the disc space.I was treated with the usual treatment of IV Vanco along with Rifidan and due to persistant symptoms of daily fevers; elevated sedrates,and WBC; along with instability of the spine, I was given a fusion with rods and screws. However, my symptoms continue with the abnormal labs with the addition of elevated globulins and a serum protein electrophoresis showing" chronic inflammation'. I've had bone scans done recently but was told that it doesn't show evidence of cont. infection in the spine. But, I was also told that one can't tell for certain when it's a chronic old infection. Also, there is a dark area (uptake?) at the exact same spot as my old bone scan that showed the infection. I was recently told that I need another surgery due to the level below my fusion breaking down. I was told that the 1 level fusion put too much stress on the level below it. But they can't tell me for sure if I still have infection in there just that it's doubtful.But I cant get answers to the daily fevers, fatigue, diarrhea, achiness etc. Also my back pain at the site of the osteomyelitis is increasing in pain and burning. I just don't know what to do w/o having more answers. Any help you can offer? Ps. I have been put through about every test and consult to r/o my symptoms coming from rheumatoloy, gastro, etc. I'm wondering if the breakdown could actually be caused from cont. infection. Also, 1 yr. ago, I began having additional symptoms involving my whole rt. side inc., my hip,buttocks front/side thigh and low abdomen on the far rt. side an inch or so away from the top of my pelvis.This inc. a vice grip pain that goes from my spine out to the rt. side. This has me scared since no one can tell me what this is. Please help any way you can. Thanks. Lin